Document Detail


Frequency and predictors of symptomatic intracranial hemorrhage after intravenous thrombolysis for acute ischemic stroke in a Brazilian public hospital.
MedLine Citation:
PMID:  22892916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Scarce data are available on the occurrence of symptomatic intracranial hemorrhage related to intravenous thrombolysis for acute stroke in South America. We aimed to address the frequency and clinical predictors of symptomatic intracranial hemorrhage after stroke thrombolysis at our tertiary emergency unit in Brazil.
METHOD: We reviewed the clinical and radiological data of 117 consecutive acute ischemic stroke patients treated with intravenous thrombolysis in our hospital between May 2001 and April 2010. We compared our results with those of the Safe Implementation of Thrombolysis in Stroke registry. Univariate and multiple regression analyses were performed to identify factors associated with symptomatic intracranial transformation.
RESULTS: In total, 113 cases from the initial sample were analyzed. The median National Institutes of Health Stroke Scale score was 16 (interquartile range: 10-20). The median onset-to-treatment time was 188 minutes (interquartile range: 155-227). There were seven symptomatic intracranial hemorrhages (6.2%; Safe Implementation of Thrombolysis in Stroke registry: 4.9%; p = 0.505). In the univariate analysis, current statin treatment and elevated National Institute of Health Stroke Scale scores were related to symptomatic intracranial hemorrhage. After the multivariate analysis, current statin treatment was the only factor independently associated with symptomatic intracranial hemorrhage.
CONCLUSIONS: In this series of Brazilian patients with severe strokes treated with intravenous thrombolysis in a public university hospital at a late treatment window, we found no increase in the rate of symptomatic intracranial hemorrhage. Additional studies are necessary to clarify the possible association between statins and the risk of symptomatic intracranial hemorrhage after stroke thrombolysis.
Authors:
Pedro Telles Cougo-Pinto; Bruno Lopes dos Santos; Francisco Antunes Dias; Soraia Ramos Cabette Fabio; Ilana Vaula Werneck; Millene Rodrigues Camilo; Daniel Giansante Abud; João Pereira Leite; Octavio Marques Pontes-Neto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinics (São Paulo, Brazil)     Volume:  67     ISSN:  1980-5322     ISO Abbreviation:  Clinics (Sao Paulo)     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-08-15     Completed Date:  2013-06-12     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  101244734     Medline TA:  Clinics (Sao Paulo)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  739-43     Citation Subset:  IM    
Affiliation:
University of São Paulo, Ribeirão Preto School of Medicine, Department of Neuroscience and Behavioral Sciences, Ribeirão Preto/SP, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Brain Ischemia / drug therapy*
Brazil / epidemiology
Female
Fibrinolytic Agents / administration & dosage,  adverse effects*
Hospitals, Public
Humans
Infusions, Intravenous
Intracranial Hemorrhages / chemically induced*,  epidemiology
Male
Middle Aged
Prospective Studies
Risk Factors
Thrombolytic Therapy / adverse effects*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents
Comments/Corrections

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