Background
The effect of prior antiplatelet (AP) therapy on the risk of hemorrhagic transformation
(HT), and on functional outcomes of acute ischemic stroke (AIS) after intravenous
thrombolysis (IVT), is not known. We performed a retrospective analysis to determine
whether history of AP therapy is associated with post-thrombolysis HT and poor prognosis
in AIS patients.
Methods
Data pertaining to 145 patients with AIS, who underwent IVT between October 2008 and
January 2015, were analyzed. The patients were divided into 2 groups based on whether
or not they had received prior AP therapy. Neurological outcomes at 24 hours and 3
months after IVT therapy were assessed. Intergroup difference in cost of treatment
was also evaluated. A multivariate logistic regression model was used to identify
independent predictors of post-thrombolysis HT.
Results
Among 145 patients, 23 (15.8%) had received prior AP therapy. On multivariate analyses,
older age (odds ratio [OR]: 1.084; confidence interval [CI], 1.028-1.144) and prior
AP therapy (OR: 3.318; CI, 1.172-9.398) were found to be independent predictors of
HT.
Conclusion
In this study, prior AP therapy was independently associated with post-thrombolysis
HT in AIS.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Guidelines for the early management of the American Heart Association/American Stroke Association.Stroke. 2013; 44: 870-947
- Classification and pathogenesis of cerebral hemorrhages after thrombolysis in ischemic stroke.Stroke. 2006; 37: 556-561
- Influence of antiplatelet pre-treatment on the risk of intracranial hemorrhage in acute ischemic stroke after intravenous thrombolysis.Eur J Neurol. 2010; 17: 301-306
- Cerebral hemorrhage stroke tissue plasminogen activator thrombolytic therapy prognosis risk factors.Chin J Neurol. 2011; 44: 754-758
- Multivariable analysis of outcome predictors and adjustment of main outcome results to baseline data profile in randomized controlled trials: Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST).Stroke. 2008; 39: 3316-3322
- Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator: a secondary analysis of the European-Australasian Acute Stroke Study (ECASS II).Stroke. 2011; 32: 438-441
- Safety of antiplatelet therapy prior to intravenous thrombolysis in acute ischemic stroke.Arch Neurol. 2008; 65: 607-611
- Intravenous thrombolysis in Thai patients with acute ischemic stroke: role of aging.J Stroke Cerebrovasc Dis. 2013; 22: 227-231
- Unfavorable neurological outcome in diabetic patients with acute ischemic stroke is associated with incomplete recanalization after intravenous thrombolysis.J Neurointervent Surg. 2015; https://doi.org/10.1136/neurintsurg-2014-011643
- Factors related to intracranial hematoma formation in patients receiving tissue-type plasminogen activator for acute ischemic stroke.Stroke. 1994; 25: 291-297
- Baseline blood pressure but not early computed tomography changes predicts major hemorrhage after streptokinase in acute ischemic stroke.Stroke. 2002; 33: 2236-2242
- Risk of intracranial hemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study.BMJ. 2015; 351: h3517
- Thrombolysis with recombinant tissue plasminogen activator under dabigatran anticoagulation in experimental stroke.Ann Neurol. 2012; 71: 624-633
Article info
Publication history
Published online: March 17, 2016
Accepted:
January 24,
2016
Received in revised form:
January 11,
2016
Received:
September 7,
2015
Footnotes
Chen and Lu contributed equally.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.038
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
