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Renal Dysfunction and In‐Hospital Outcomes in Patients With Acute Ischemic Stroke After Intravenous Thrombolytic Therapy

Renal Dysfunction and In‐Hospital Outcomes in Patients With Acute Ischemic Stroke After Intravenous Thrombolytic Therapy

Authors :
Yongjun Wang
Xin Yang
Yilong Wang
Ying Xian
Zhen-Zhen Rao
Xianwei Wang
Chunjuan Wang
Zixiao Li
Xingquan Zhao
Xuewei Xie
Rui-Ping Xiao
Hongqiu Gu
Source :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Publication Year :
2019
Publisher :
John Wiley and Sons Inc., 2019.

Abstract

Background The impact of estimated glomerular filtration rate ( eGFR ) on clinical short‐term outcomes after stroke thrombolysis with tissue plasminogen activator remains controversial. Methods and Results We analyzed 18 320 ischemic stroke patients who received intravenous tissue plasminogen activator at participating hospitals in the Chinese Stroke Center Alliance between June 2015 and November 2017. Multivariate logistic regression models were used to evaluate associations between eGFR (2 ) and in‐hospital mortality and symptomatic intracerebral hemorrhage, adjusting for patient and hospital characteristics and the hospital clustering effect. Of the 18 320 patients receiving tissue plasminogen activator, 601 (3.3%) had an eGFR eGFR 45 to 59, 3679 (20.1%) had an eGFR 60 to 89, and 13 415 (73.2%) had an eGFR ≥90. As compared with eGFR ≥90, eGFR values CI , 2.18–5.91), 45 to 59 (4.0% versus 0.9%, adjusted odds ratio, 2.00; 95% CI , 1.18–3.38), and 60 to 89 (2.5% versus 0.9%, adjusted odds ratio, 1.67; 95% CI , 1.20–2.34) were independently associated with increased odds of in‐hospital mortality. However, there was no statistically significant association between eGFR and symptomatic intracerebral hemorrhage. Conclusions eGFR was associated with an increased risk of in‐hospital mortality in acute ischemic stroke patients after treatment with tissue plasminogen activator. eGFR is an important predictor of poststroke short‐term death but not of symptomatic intracerebral hemorrhage.

Details

Language :
English
ISSN :
20479980
Volume :
8
Issue :
20
Database :
OpenAIRE
Journal :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Accession number :
edsair.doi.dedup.....61baa4a18279de317717034acb16d1cb