Thrombolytic therapy with intravenous recombinant tissue plasminogen activator in Japanese older patients with acute ischemic stroke: Fukuoka Stroke Registry

2013 ◽  
Vol 14 (4) ◽  
pp. 954-959 ◽  
Author(s):  
Ryu Matsuo ◽  
Masahiro Kamouchi ◽  
Tetsuro Ago ◽  
Jun Hata ◽  
Yuji Shono ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Older Patients ◽  
Recombinant Tissue Plasminogen Activator ◽  
Stroke Registry ◽  
Tissue Plasminogen

PREDICTORS THE RISK OF SYMPTOMATIC INTRACEREBRAL HEAMORHAGE AFTER THROMBOLYTIC THERAPY WITH RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR IN ACUTE ISCHEMIC STROKE

2017 ◽  
pp. 64-67
Author(s):  
Dinh Thuyen Nguyen ◽  
Duy Ton Mai ◽  
Viet Phuong Dao ◽  
Anh Tuan Nguyen
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Recombinant Tissue Plasminogen Activator ◽  
Brain Ct ◽  
Tissue Plasminogen ◽  
History Of ◽  
Stroke Thrombolysis

Objective: to evaluate predictors the risk of symptomatic intracerebral heamorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke. Methods: observative study on 54 patients with acute ischemic stroke at Emergency Department, Bach Mai hospital from 01/2010 to 10/2016. Results: Predictors the risk of symptomatic intracerebral heamorrhage were: age above 70 (OR 2,76; 95% CI 0,73 – 10,52; p = 0,12), time from onset to treatment (OR 1,03; 95% CI 0,34 – 3,13; p = 0,95), systolic blood pressure ≥ 140 mmHg (OR 2,0; 95% CI 0,61 – 6,51; p = 0,24), NIHSS score above 12 (OR 3,13; 95% CI 0,63 – 15,51; p = 0,138), glycemia above 10 mmol/l (OR 8,94; 95% CI 1,51 – 51,73; p = 0,003), fibrillation atrial (OR 1,49; 95% 0,49 – 4,56; p = 0,33), history of diebete (OR 6,4; 95% CI 0,67 – 61,03; p = 0,06), history of anticoagulation (OR 1,07; 95% CI 0,22 – 5,11; p = 0,63), history of cerebral infarction (OR 1,49; 95% CI 0,183 – 12,184; p = 0,707), sign of early brain CT (OR 6,14; 95% CI 1,01 – 39,93; p = 0,048). Conclusion: glucose above 10 mmol/l and sign of early brain CT were predictors the risk of symptomatic intracerebral heamorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke. Key words: stroke, thrombolysis, predictor, heamorrhage conversion

Thrombolytic Therapy for Acute Ischemic Stroke: What Cardiac Physicians Need to Know

1996 ◽  
Vol 4 (4) ◽  
pp. 196-200
Author(s):  
Roger L White
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Recombinant Tissue Plasminogen Activator ◽  
Current Status ◽  
Tissue Plasminogen

The current status of thrombolytic therapy for acute ischemic stroke is reviewed in relation to early work and to the use of thrombolytic agents in acute myocardial infarction. The case of a patient treated with recombinant tissue plasminogen activator for acute ischemic stroke is described to illustrate the improvement in outcome that can be achieved with this therapy in selected patients. A number of recommendations are included for cardiologists on the use of plasminogen activator in acute ischemic stroke regarding the timing, dosage, selection, and monitoring of patients.

Association of admission leukocyte count with clinical outcomes in acute ischemic stroke patients undergoing intravenous thrombolysis with recombinant tissue plasminogen activator

2020 ◽  
Vol 17 ◽  
Author(s):  
Jie Chen ◽  
Fu-Liang Zhang ◽  
Shan Lv ◽  
Hang Jin ◽  
Yun Luo ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Leukocyte Count ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Functional Independence ◽  
Tissue Plasminogen ◽  
Poor Outcomes

Objective:: Increased leukocyte count are positively associated with poor outcomes and all-cause mortality in coronary heart disease, cancer, and ischemic stroke. The role of leukocyte count in acute ischemic stroke (AIS) remains important. We aimed to investigate the association between admission leukocyte count before thrombolysis with recombinant tissue plasminogen activator (rt-PA) and 3-month outcomes in AIS patients. Methods:: This retrospective study included consecutive AIS patients who received intravenous (IV) rt-PA within 4.5 h of symptom onset between January 2016 and December 2018. We assessed outcomes including short-term hemorrhagic transformation (HT), 3-month mortality, and functional independence (modified Rankin Scale [mRS] score of 0–2 or 0–1). Results:: Among 579 patients who received IV rt-PA, 77 (13.3%) exhibited HT at 24 h, 43 (7.4%) died within 3 months, and 211 (36.4%) exhibited functional independence (mRS score: 0–2). Multivariable logistic regression revealed admission leukocyte count as an independent predictor of good and excellent outcomes at 3 months. Each 1-point increase in admission leukocyte count increased the odds of poor outcomes at 3 months by 7.6% (mRS score: 3–6, odds ratio (OR): 1.076, 95% confidence interval (CI): 1.003–1.154, p=0.041) and 7.8% (mRS score: 2–6, OR: 1.078, 95% CI: 1.006–1.154, p=0.033). Multivariable regression analysis revealed no association between HT and 3-month mortality. Admission neutrophil and lymphocyte count were not associated with 3-month functional outcomes or 3-month mortality. Conclusion:: Lower admission leukocyte count independently predicts good and excellent outcomes at 3 months in AIS patients undergoing rt-PA treatment.

Abstract TP286: A Literature Review of Cost-effectiveness of Intravenous Recombinant Tissue Plasminogen Activator for Treating Acute Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Guijing Wang ◽  
Heesoo Joo ◽  
Mary G George
Keyword(s):  
Ischemic Stroke ◽  
Cost Effectiveness ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Cost Effective ◽  
Recombinant Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
The Cost ◽  
Effectiveness Studies

Introduction: Intravenous recombinant tissue plasminogen activator (IV rtPA) is recommended treatment for acute ischemic stroke patients, but the cost-effectiveness of IV rtPA within different time windows after the onset of acute ischemic stroke is not well reviewed. Objectives: We conducted a literature review of the cost-effectiveness studies about IV rtPA. Methods: A literature search was conducted using PubMed, MEDLINE, and EconLit, with the key words stroke, cost, economic benefit, saving, cost-effectiveness, tissue plasminogen activator, and rtPA. The review is limited to original research articles published during 1995–2014 in English-language peer-reviewed journals. Results: We found 15 studies meeting our criteria for this review. Nine of them were cost-effectiveness studies of IV rtPA treatment within 0-3 hours after stroke onset, 2 studies within 3-4.5 hours, 3 studies within 0-4.5 hours, and 1 study within 0-6 hours. IV rtPA is a cost-saving or a cost-effectiveness strategy from most of the study results. Only one study showed incremental cost-effectiveness ratio of IV rtPA within one year was marginally above $50,000 per QALY threshold. IV rtPA within 0-3 hours after stroke led to cost savings for lifetime or 30 years, and IV rtPA within 3-4.5 hours after stroke increased costs but still was cost-effective. Conclusions: The literature generally showed that intravenous IV rtPA was a dominant or a cost-effective strategy compared to traditional treatment for acute ischemic stroke patients without IV rtPA. The findings from the literature lacked generalizability because of limited data and various assumptions.

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