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Abstract TMP79: Use of Intravenous Tissue Plasminogen Activator in Patients With History of Prior Stroke Plus Diabetes Mellitus
- Source :
- Stroke. 50
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Background: Patients with history of diabetes mellitus (DM) plus prior ischemic stroke were excluded from ECASS III trial due to safety concerns. However, there are few data on use of intravenous tissue plasminogen activator (IV tPA) and risk of symptomatic intracranial hemorrhage (sICH) or outcomes in this population. Methods: Using data from the Get With The Guidelines-Stroke Registry (GWTG-Stroke) between February 2009 and September 2017 (n=1619 hospitals), we examined characteristics and outcomes among AIS patients treated with tPA within the 3-4.5 hour window who had a history of prior stroke and DM (n=2129) versus those without either history (n=16,690). Results: Compared with patients without either history, those with prior stroke and DM had a higher prevalence of cardiovascular risk factors and more severe stroke (Table). The unadjusted rates of sICH and in-hospital mortality were 4.3% vs 3.8% and 6.2% vs 5.5%, respectively. These differences were not statistically significant after risk adjustment (sICH, adjusted odds ratio [OR] 0.79[95% CI, 0.51-1.21], p=0.28; in-hospital mortality OR 0.77 [95% CI, 0.52-1.14], p=0.19). Unadjusted rate of functional independence (Modified Rankin Scale score [mRS] 0-2) at discharge was lower in those with history of prior stroke and diabetes (30.9% vs 44.8%, p= Conclusion: Among AIS patients treated with intravenous tPA within the 3-4.5 hour window, history of prior stroke plus DM was not associated with statistically significant increased sICH or mortality risk.
- Subjects :
- Advanced and Specialized Nursing
medicine.medical_specialty
business.industry
medicine.medical_treatment
Thrombolysis
030204 cardiovascular system & hematology
medicine.disease
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diabetes mellitus
Ischemic stroke
Cardiology
medicine
In patient
Neurology (clinical)
Intravenous tissue plasminogen activator
Cardiology and Cardiovascular Medicine
business
Stroke
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15244628 and 00392499
- Volume :
- 50
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi...........c8ba1c499a9cdbb016646a58f106d9e8