Clinical Outcomes of Intravenous Recombinant Tissue Plasminogen Activator Therapy in Acute Ischemic Stroke Patients
Clinical Outcomes of Treating Acute Ischemic Stroke Patients
Keywords:
acute ischemic stroke (AIS), intravenous recombinant tissue plasminogen activator (rt-PA), clinical outcomesAbstract
The treatment of acute ischemic stroke (AIS) with intravenous recombinant tissue plasminogen activator (rt- PA) is standard practice. This retrospective cohort study compared clinical outcomes in AIS patients who either received or not received rt-PA. Data were collected from medical and electronic records of the patients in the Stroke Ward at Somdejprajaotaksinmaharaj Hospital from January 2017-December 2021. Of the 1,635 patients, 901 were male, and their mean age was 65 years. Efficacy at 24 hours in the rt-PA-treated group was decreased by more than 4 points in neurologic NIHSS score, significantly greater than the non- rt-PA-treated group [48% and 12%, respectively (p < 0.001)]. At three months after AIS, 70% of patients in the rt-PA group were significantly able to live independently compared to 39% in the other group (p < 0.001). However, the mortality within three months was similar in both groups (3.8% vs 4.3%). The incidence of 24-hour intracerebral hemorrhage was significantly higher in the rt- PA group than in the non-rt-PA group (6% and 0.6%, respectively; p < 0.001). The symptomatic intracerebral hemorrhage in both groups was not different. In conclusion, the treatment of AIS patients with intravenous rt-PA injection within 4.5 hours after symptoms onset is an effective and safe method.
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