Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：EClinicalMedicine

Publication type: Original Articles

IF(IF): 10

PMID: 41048664 Link To Pubmed Full text Download

Current guidelines recommend intravenous alteplase for patients with acute ischemic stroke (AIS) presenting within 4.5 hours of symptom onset. Minor stroke, defined as a National Institutes of Health Stroke Scale (NIHSS) score less than or equal to 5, accounted for approximately half of patients with AIS in 2016 (50.0%) and in 2019 (46.9%), but the evidence in support of intravenous thrombolysis for these patients has remained inconclusive. Most published guidelines for acute ischaemic stroke suggest thrombolytic therapy to treat patients with a disabling minor ischaemic stroke within 4.5 hours, while most guidelines do not recommend thrombolysis in patients with non-disabling minor strokes. However, disabling stroke has not been defined well. The challenge is to identify which minor stroke should be aggressively treated.

The results for continuous variables are shown as mean and standard deviation (SD) (normal distribution), while categorical variables are shown as number and percentage. For the primary outcome analysis in all minor strokes, we employed a generalized linear model (GLM) with binomial distribution and log link function to calculate the relative risk (RR), accompanied by two- sided 95% confidence intervals (CI). Risk difference (RD) with 95% CIs were also computed using GLMs with binomial distribution and identity link function. We performed subgroup analyses stratified by age (≤65 vs. >65 years), sex (male vs. female), BMI (≤25 vs. >25 kg/m2), baseline stroke severity (NIHSS score ≤3 vs. >3), NIHSS subitems, and TOAST subtypes (large artery atherosclerosis [LAA], cardioembolism, small artery occlusion, other/ undetermined).