Document Detail


Early recovery and functional outcome are related with causal stroke subtype: data from the tinzaparin in acute ischemic stroke trial.
MedLine Citation:
PMID:  17689415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Baseline severity and causal subtype are predictors of outcome in ischemic stroke. We used data from the Tinzaparin in Acute Ischemic Stroke Trial (TAIST) to further assess the relationship among stroke subtype, early recovery, and outcome. METHODS: Patients with ischemic stroke (<48 hours ictus) and enrolled into TAIST were included. Severity was measured prospectively as the Scandinavian Neurological Stroke Scale (SNSS) at days 0, 4, 7, and 10. Causal subtype as large artery atherosclerosis (LAA), cardioembolism (CE), or small vessel occlusion (SVO) was assigned after standard investigations. The rate of recovery was calculated as the change in SNSS at each time point. Functional outcome was assessed using the modified Rankin Scale (mRS) and Barthel Index at day 90. RESULTS: Analyses were performed on the 1190 patients in TAIST who met criteria for LAA, CE, and SVO. The largest change in SNSS score occurred between baseline and day 4 and was greatest in SVO (median improvement 4 U), compared with LAA (median improvement 2 U) and CE (median improvement 2 U) (P < .0001). If no improvement in SNSS had occurred by day 4, irrespective of subgroup, then early recovery (median SNSS improvement by day 10: 2) and functional outcome (mRS 4) tended to be limited; patients who recovered early tended to continue to improve (median SNSS improvement by day 10: 11) and had a better outcome at day 90 (median, mRS 2). CONCLUSIONS: Recovery is related to causal subtype. In all subtypes most recovery occurred by day 4, and was predictive of longer-term functional outcome.
Authors:
Nikola Sprigg; Laura J Gray; Philip M W Bath; Ewa Lindenstrøm; Gudrun Boysen; Peter Paul De Deyn; Pal Friis; Didier Leys; Reijo Marttila; Jan-Edwin Olsson; Desmond O'Neill; Erich Bernd Ringelstein; Jan-Jacob van der Sande; Alexander G G Turpie;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  16     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:    2007 Jul-Aug
Date Detail:
Created Date:  2007-08-10     Completed Date:  2007-09-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  180-4     Citation Subset:  IM    
Affiliation:
Institute of Neuroscience, University of Nottingham, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / administration & dosage,  therapeutic use*
Arterioles
Aspirin / administration & dosage,  therapeutic use
Brain Ischemia / classification,  drug therapy*,  etiology
Cerebral Arteries
Drug Therapy, Combination
Female
Heparin, Low-Molecular-Weight / administration & dosage,  therapeutic use*
Humans
Intracranial Arteriosclerosis / complications*
Intracranial Embolism / complications*
Male
Middle Aged
Platelet Aggregation Inhibitors / administration & dosage,  therapeutic use
Prognosis
Prospective Studies
Randomized Controlled Trials as Topic / statistics & numerical data
Recovery of Function
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight; 0/Platelet Aggregation Inhibitors; 0/tinzaparin; 50-78-2/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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