Japan Alteplase Clinical Trial (J-ACT): Efficacy and Safety Study of Tissue Plasminogen Activator (Alteplase) for Ischemic Stroke

Exclusion criteria

• ✕. patients with rapidly improving neurological symptoms or with minor neurological deficit (National Institutes of Health Stroke Scale (NIHSS) score of ≤4) prior to the start of treatment
• ✕. Computed Tomography (CT) evidence of non-minor early ischemic signs (minor early ischemic sign was defined as the involvement of one-third or less of the middle cerebral artery area)
• ✕. CT evidence of cerebral hemorrhage or subarachnoid hemorrhage
• ✕. symptoms suggestive of subarachnoid hemorrhage
• ✕. lactation, pregnancy or suggestive pregnancy; menstruation
• ✕. platelet count below 100,000/mm3
• ✕. heparin administration within 48 hours preceding stroke onset with an elevated activated partial thromboplastin time (APTT); current use of oral anticoagulants with an International Normalized Ratio (INR) of ≥1.7; use of drugs not allowed to be administered concomitantly with alteplase (other thrombolytic agents, ozagrel sodium, argatroban and edaravone) prior to the study treatment
• ✕. major surgery or serious trauma within the preceding 14 days; serious head or spinal cord trauma within the preceding 3 months