• Cardiac care
• thrombolysis
• neurology
• stroke

I would like to comment on the negative findings of the recently published best evidence topic report on the use of thrombolysis in acute ischaemic stroke (AIS).1

1. The meta-analysis by Wardlaw et al for the Cochrane Collaboration was updated in 2009 and now includes data on 26 trials including 7152 patients.2 Its conclusions are unchanged from the 2003 version but the same concerns remain. The dataset includes a heterogeneous group of clinical trials with only approximately 55% of the data from trials testing recombinant tissue plasminogen activator (rtPA). Despite this the meta-analysis demonstrated that thrombolytic therapy administered less than 6 h after the onset of AIS significantly …