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[Safety of intravenous thrombolysis in cerebral microbleeds patients with prior antiplatelet therapy].
- Source :
-
Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences [Zhejiang Da Xue Xue Bao Yi Xue Ban] 2015 Nov; Vol. 44 (6), pp. 618-24. - Publication Year :
- 2015
-
Abstract
- Objective: To evaluate the safety of intravenous thrombolysis (IVT) in cerebral microbleeds (CMBs) patients with prior antiplatelet therapy.<br />Methods: Four hundred and forty nine patients with acute ischemic stroke aged (66.8 ± 12.9) years, including 298 males and 151 females, underwent susceptibility-weighted imaging (SWI) examination and MRI-guided IVT therapy between June 2009 and June 2015. The presence of CMBs, previous antiplatelet therapy, HT subtypes according to ECASS II criteria and functional outcome based on modified Rankin scale (mRS) at 3 months were analyzed in logistic regression model.<br />Results: Total 934 CMBs were detected in 172 (38.3%) patients, among whom 63 (14.0%) previously received antiplatelet therapy. All patients received intravenous recombinant tissue-plasminogen activator (rt-PA) for thrombolysis with the onset-to needle time of (229.0 ± 103.7) min. The pretreatment National Institutes of Health Stroke Scale (NIHSS) score was 10 (IQR 5-15). Logistic regression analysis indicated that prior antiplatelet use increased neither risk of parenchymal hematoma (PH) (OR=0.809,95% CI:0.201-3.262, P=0.766) nor adverse functional outcome (OR=1.517, 95% CI:0.504-4.568, P=0.459) in patients with CMBs; while in patients with multiple CMBs (≥ 3) prior antiplatelet use increased risk of hemorrhagic transformation (OR=9.737, 95% CI: 1.364-69.494, P=0.023), but not adverse functional outcome (OR=1.697, 95% CI:0.275-10.487, P=0.569).<br />Conclusion: The study indicates that in patients with CMBs, thrombolytic therapy should not be excluded due to the prior use of antiplatelet; however, the larger prospective studies are needed in future for patients with multiple CMBs.
- Subjects :
- Aged
Female
Humans
Logistic Models
Magnetic Resonance Imaging
Male
Middle Aged
Prospective Studies
Recombinant Proteins administration & dosage
Recombinant Proteins therapeutic use
Tissue Plasminogen Activator administration & dosage
United States
Brain Ischemia drug therapy
Cerebral Hemorrhage drug therapy
Stroke drug therapy
Thrombolytic Therapy
Tissue Plasminogen Activator therapeutic use
Subjects
Details
- Language :
- Chinese
- ISSN :
- 1008-9292
- Volume :
- 44
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences
- Publication Type :
- Academic Journal
- Accession number :
- 26822043
- Full Text :
- https://doi.org/10.3785/j.issn.1008-9292.2015.11.04