BC 073 – Altéplase dans l’AVC ischémique aigu entre 4,5 et 24 heures (étude HOPE)

Épisode de BaladoCritique - club de lecture médical par Dr Luc Lanthier et collaborateurs · 28 octobre 2025 · 48 min

Dans cette 73e baladodiffusion, les Drs Luc Lanthier et Emmanuelle Lapointe discutent du traitement thrombolytique retardé dans l’AVC ischémique aigu, en plus de réviser la littérature médicale de juillet, août et septembre 2025.

Quiz clinique (2 min 16), présentation principale (2 min 38), critique (26 min 42), retour sur le cas clinique (36 min 05), autres articles (37 min 50), réponse au quiz clinique (44 min 57)

Référence principale :

Zhou Y, He Y, Campbell BCV, Liebeskind DS, Yuan C, Chen H, et al. Alteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: The HOPE Randomized Clinical Trial. JAMA. 2025;334(9):788-97. PubMed PMID: 40773205.

Articles associés :

Thomalla G, Simonsen CZ, Boutitie F, Andersen G, Berthezene Y, Cheng B, et al. MRI-Guided Thrombolysis for Stroke with Unknown Time of Onset. N Engl J Med. 2018;379(7):611-22. PubMed PMID: 29766770.

Ma H, Campbell BCV, Parsons MW, Churilov L, Levi CR, Hsu C, et al. Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke. N Engl J Med. 2019;380(19):1795-803. PubMed PMID: 31067369.

Albers GW, Jumaa M, Purdon B, Zaidi SF, Streib C, Shuaib A, et al. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. N Engl J Med. 2024;390(8):701-11. PubMed PMID: 38329148.

Tenecteplase for Ischemic Stroke at 4.5 to 24 Hours without Thrombectomy. N Engl J Med. 2024;391(3):203-12. PubMed PMID: 38884324.

Wang Z, Li J, Wang X, Yuan B, Li J, Ma Q. Tenecteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: A Meta-Analysis of Randomized Controlled Trials. Stroke. 2025 Oct 13. doi: 10.1161/STROKEAHA.125.053256. PubMed PMID: 41078125.

Autres articles d’intérêt récent :

Aronne LJ, Horn DB, le Roux CW, Ho W, Falcon BL, Gomez Valderas E, et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025;393(1):26-36. PubMed PMID: 40353578.

Kahlmann V, Janssen Bonas M, Moor CC, Grutters JC, Mostard RLM, van Rijswijk H, et al. First-Line Treatment of Pulmonary Sarcoidosis with Prednisone or Methotrexate. N Engl J Med. 2025;393(3):231-42. PubMed PMID: 40387020.

Desai AS, Karns AD, Badariene J, Aswad A, Neutel JM, Kazi F, et al. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension: The KARDIA-2 Randomized Clinical Trial. JAMA. 2025;334(1):46-55. PubMed PMID: 40434761.

Agarwal R, Green JB, Heerspink HJL, Mann JFE, McGill JB, Mottl AK, et al. Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes. N Engl J Med. 2025;393(6):533-43. PubMed PMID: 40470996.

McIntyre L, Fergusson D, McArdle T, English S, Cook DJ, Fox-Robichaud AE, et al. A Crossover Trial of Hospital-Wide Lactated Ringer’s Solution versus Normal Saline. N Engl J Med. 2025;393(7):660-70. PubMed PMID: 40503714.

Davies MJ, Bajaj HS, Broholm C, Eliasen A, Garvey WT, le Roux CW, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. N Engl J Med. 2025;393(7):648-59. PubMed PMID: 40544432.

Garvey WT, Bluher M, Osorto Contreras CK, Davies MJ, Winning Lehmann E, Pietilainen KH, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2025;393(7):635-47. PubMed PMID: 40544433.

Ding D, Nguyen B, Nau T, Luo M, Del Pozo Cruz B, Dempsey PC, et al. Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis. Lancet Public Health. 2025;10(8):e668-e81. PubMed PMID: 40713949.

Tonet E, Raisi A, Zagnoni S, Chiaranda G, Pasanisi G, Aschieri D, et al. Multidomain Rehabilitation for Older Patients with Myocardial Infarction. N Engl J Med. 2025;393(10):973-82. PubMed PMID: 40879431.

Rosenstock J, Hsia S, Nevarez Ruiz L, Eyde S, Cox D, Wu WS, et al. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes. N Engl J Med. 2025;393(11):1065-76. PubMed PMID: 40544435.

Tao C, Liu T, Cui T, Liu J, Li Z, Ren Y, et al. Early Tirofiban Infusion after Intravenous Thrombolysis for Stroke. N Engl J Med. 2025;393(12):1191-201. PubMed PMID: 40616232.

Bavendiek U, Grosshennig A, Schwab J, Berliner D, Rieth A, Maier LS, et al. Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2025;393(12):1155-65. PubMed PMID: 40879434.

Piazza G, Bikdeli B, Pandey AK, Krishnathasan D, Khairani CD, Bejjani A, et al. Apixaban for Extended Treatment of Provoked Venous Thromboembolism. N Engl J Med. 2025;393(12):1166-76. PubMed PMID: 40888734.

Florian J, Salcedo P, Burkhart K, Shah A, Chekka LMS, Keshishi D, et al. Cannabidiol and Liver Enzyme Level Elevations in Healthy Adults: A Randomized Clinical Trial. JAMA Intern Med. 2025;185(9):1070-8. PubMed PMID: 40622698.

Guides de pratique :

Podolanczuk AJ, Hunninghake GM, Wilson KC, Khor YH, Kheir F, Pang B, et al. Approach to the Evaluation and Management of Interstitial Lung Abnormalities: An Official American Thoracic Society Clinical Statement. Am J Respir Crit Care Med. 2025;211(7):1132-55. PubMed PMID: 40387336.

Adler GK, Stowasser M, Correa RR, Khan N, Kline G, McGowan MJ, et al. Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2025;110(9):2453-95. PubMed PMID: 40658480.

Pedersen SD, Manjoo P, Dash S, Jain A, Pearce N, Poddar M. Pharmacotherapy for obesity management in adults: 2025 clinical practice guideline update. CMAJ. 2025;197(27):E797-E809. PubMed PMID: 40789597.

Thombs BD, Traversy G, Reynolds DL, Lang E, Groulx S, Wilson BJ, et al. Recommendations on interventions for tobacco smoking cessation in adults in Canada. CMAJ. 2025;197(28):E846-E61. PubMed PMID: 40854602

Writing Committee M, Jones DW, Ferdinand KC, Taler SJ, Johnson HM, Shimbo D, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;152(11):e114-e218. PubMed PMID: 40811497.

Référence du quiz clinique :

Livingston G, Huntley J, Liu KY, Costafreda SG, Selbaek G, Alladi S, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024;404(10452):572-628. PubMed PMID: 39096926.

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