Document Detail


Recanalization within one hour after intravenous tissue plasminogen activator is associated with favorable outcome in acute stroke patients.
MedLine Citation:
PMID:  20516694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIM: Early recanalization after tissue plasminogen activator (t-PA) infusion greatly improves outcome in stroke patients. However, the time threshold of early recanalization for a favorable outcome remains unclear. The aim of this study was to assess patient outcome 3 months after t-PA therapy among patients with early, delayed and without recanalization. METHODS: Consecutive patients with major brain artery occlusion on magnetic resonance angiography (MRA) before t-PA infusion were enrolled. We divided the patients into 3 groups according to the findings of follow-up MRA 1 and 24 h after t-PA: the early group who had recanalization within 1 h after t-PA; the delayed group who had recanalization between 1 and 24 h, and the no recanalization group. We then assessed the outcomes (modified Rankin score 0-1) 3 months after t-PA therapy among the 3 groups. RESULTS: A total of 92 patients (53 men, mean age 75.8 +/- 10.3 years) were enrolled. A favorable outcome was most frequently observed in the early group (n = 39, 40.6%), followed by the delayed group (n = 25, 18.2%), and the no recanalization group (n = 28, 10.5%; p = 0.037). After adjusting for age, atrial fibrillation and NIHSS score, the adjusted OR for early recanalization when compared with no recanalization was 7.11 (95% CI 1.177-43.063; p = 0.032) for a favorable outcome, while the adjusted OR for delayed recanalization was 1.75 (95% CI 0.104-29.356; p = 0.698). CONCLUSION: Early recanalization within 1 h after intravenous t-PA is associated with a favorable outcome in stroke patients.
Authors:
Kazumi Kimura; Yasuyuki Iguchi; Kensaku Shibazaki; Junya Aoki; Masao Watanabe; Kazuto Kobayashi; Yuki Sakamoto
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Publication Detail:
Type:  Journal Article     Date:  2010-06-03
Journal Detail:
Title:  European neurology     Volume:  63     ISSN:  1421-9913     ISO Abbreviation:  Eur. Neurol.     Publication Date:  2010  
Date Detail:
Created Date:  2010-07-09     Completed Date:  2010-10-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150760     Medline TA:  Eur Neurol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan. kimurak@med.kawasaki-m.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cerebral Hemorrhage / etiology
Female
Fibrinolytic Agents / pharmacology,  therapeutic use*
Follow-Up Studies
Humans
Infusions, Intravenous / methods
Male
Recovery of Function / drug effects
Retrospective Studies
Stroke / drug therapy*
Time Factors
Tissue Plasminogen Activator / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator

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