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The use of alteplase, although safe, does not offer clear clinical advantages when mild stroke is non-disabling.
- Source :
- Frontiers in Neurology; 2023, p1-8, 8p
- Publication Year :
- 2023
-
Abstract
- Introduction: It is unknown whether alteplase is effective and safe in patients with mild acute ischemic stroke (AIS). Determining whether symptoms are "disabling" or not is a crucial factor in the management of these patients. This study aimed to investigate the efficacy and safety of alteplase in patients with mild, non-disabling AIS. Methods: We included all consecutive patients admitted for AIS at our institution fromJanuary 2015 to May 2022 who presented a baseline NIHSS score of 0-5 and fit the criteria to receive intravenous thrombolysis. In order to select only subjects with non-disabling AIS, we excluded patients who scoredmore than 1 point in the following NIHSS single items: vision, language, neglect, and single limb. Patients who scored at least 1 point in the NIHSS consciousness item were excluded as well. This study is a retrospective analysis of a prospectively collected database. Results: After the application of the exclusion criteria, we included 319 patients, stratified into patients receiving and not receiving alteplase based on non-disabling symptoms. The two groups were comparable regarding demographic and clinical data. Rates of a 3-month favorable outcome, defined as a 3-month mRS score of 0-1, were similar, being 82.3% and 86.1% in the treated and untreated patients, respectively. Hemorrhagic complications and mortality occurred infrequently and were not affected by alteplase treatment. Discussion: This observational study suggests that the use of alteplase, although safe, is not associated with a better outcome in highly selected patients with non-disabling AIS. [ABSTRACT FROM AUTHOR]
- Subjects :
- THROMBOLYTIC therapy
STROKE
STROKE patients
ALTEPLASE
Subjects
Details
- Language :
- English
- ISSN :
- 16642295
- Database :
- Complementary Index
- Journal :
- Frontiers in Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 169771543
- Full Text :
- https://doi.org/10.3389/fneur.2023.1212712