国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Intravenous Thrombolysis Is Safe and Effective for the Cryptogenic Stroke in China: Data From the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)
第一作者：Yu Fan
基本信息
- 负责人：Yu Fan
- 数据来源： TIMS-CHINA
- 论文编号：OTHERS20190233
- 发表时间：2019-01-01
2019-01-01
已发表文章
发表杂志：J Stroke Cerebrovasc Dis.
发表类型: Original Contributions
影响因子(IF): 1.646
PMID: 30366863 Pubmed原文链接 全文下载
主要研究背景及目的
The intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) therapy is safe and efficient during the treatment of acute ischemic stroke. Nonetheless, the different outcomes among various stroke subgroups have lim- ited data with regard to the safety and efficacy of cryptogenic stroke (CS). The present study compared the safety and efficacy when IVT with rt-PA was used for the treat- ment of CS and the other stroke subtypes.
方法
This study classified the IVT with rt-PA patients within 4.5 hours after stroke onset, based on the trial of ORG 10172 in acute stroke treatment criteria in terms of diagnostic evaluation. The data were obtained from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database, a large multicenter prospective registry. A multivariable logistic regression model was employed to compare the differences between the sub- types in symptomatic intracerebral hemorrhage (sICH) within 7 days and studied the mortality and the outcome during 90 days.
结论
IVT with rt-PA is a safe and effective method for the treatment of CS patients.
主要结果
In total, 1118 patients were recruited; of these, 131 (11.7%) suffered from CS and 987 (88.3%) with the other etiol- ogy. In the CS group, patients were younger than those in the other etiology groups (P < .001). Moreover, it had a lower prevalence of previous stroke (P = .0117), receiving antiplatelet drug in 24 hours prior to thrombolysis (P = .0017), and functional indepen- dence (mRS > 1 before stroke, P = .003). The CS group had lower blood pressure (sys- tolic blood pressure P = .0001; diastolic blood pressure; P = .0212) before thrombolysis, atrial fibrillation (P < .001), and diabetes mellitus (P = .0005). Transient ischemic attack, hypertension, hyperlipidemia, blood glucose, receiving anticoagulants in 24 hours prior to thrombolysis, and standard dosage of rt-PA were equally distributed in both groups. After the adjustment of confounders between the CS and the other subgroups, no obvious differences were observed in sICH rate and mortality (P > .05) The CS patients exhibited excellent recovery (mRS, 0-1; 63.78%) and functional independence (mRS, 0-2; 74.8%) than the large artery atherosclerosis patients.