Intravenous Thrombolysis in Unknown-Onset Stroke Results From the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Registry

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F17%3A10373860" target="_blank" >RIV/00216208:11130/17:10373860 - isvavai.cz</a>

Alternative codes found

RIV/00064203:_____/17:10373860

Result on the web

<a href="https://doi.org/10.1161/STROKEAHA.116.014889" target="_blank" >https://doi.org/10.1161/STROKEAHA.116.014889</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1161/STROKEAHA.116.014889" target="_blank" >10.1161/STROKEAHA.116.014889</a>

Result language

angličtina

Original language name

Intravenous Thrombolysis in Unknown-Onset Stroke Results From the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Registry

Original language description

Background and Purpose-Stroke patients with unknown onset (UKO) are excluded from thrombolytic therapy. We aim to study the safety and efficacy of intravenous alteplase in ischemic stroke patients with UKO of symptoms compared with those treated within 4.5 hours in a large cohort. Methods-Data were analyzed from 47237 patients with acute ischemic stroke receiving intravenous tissue-type plasminogen activator in hospitals participating in the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Registry between 2010 and 2014. Two groups were defined: (1) patients with UKO (n=502) and (2) patients treated within 4.5 hours of stroke onset (n=44875). Outcome measures were symptomatic intracerebral hemorrhage per Safe Implementation of Treatment in Stroke on the 22 to 36 hours post-treatment neuroimaging and mortality and functional outcome assessed by the modified Rankin Scale at 3 months. Results-Patients in UKO group were significantly older, had more severe stroke at baseline, and longer door-to-needle times than patients in the 4.5 hours group. Logistic regression showed similar risk of symptomatic intracerebral hemorrhage (adjusted odds ratio, 1.09; 95% confidence interval, 0.44-2.67) and no significant differences in functional independency (modified Rankin Scale score of 0-2; adjusted odds ratio, 0.79; 95% confidence interval, 0.56-1.10), but higher mortality (adjusted odds ratio, 1.58; 95% confidence interval, 1.04-2.41) in the UKO group compared with the 4.5 hours group. Patients treated within 4.5 hours showed reduced disability over the entire range of modified Rankin Scale compared with the UKO group (common adjusted odds ratio, 1.29; 95% confidence interval, 1.01-1.65). Conclusions-Our data suggest no excess risk of symptomatic intracerebral hemorrhage but increased mortality and reduced favorable outcome in patients with UKO stroke compared with patients treated within the approved time window.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30103 - Neurosciences (including psychophysiology)

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Stroke

ISSN

0039-2499

e-ISSN

—

Volume of the periodical

48

Issue of the periodical within the volume

3

Country of publishing house

US - UNITED STATES

Number of pages

6

Pages from-to

720-725

UT code for WoS article

000395551400039

EID of the result in the Scopus database

2-s2.0-85011876459