Prestroke Antiplatelet Effect on Symptomatic Intracranial Hemorrhage and Functional Outcome in Intravenous Thrombolysis / 대한뇌졸중학회지
Jay-Chol CHOI; Ji-Sung LEE; Tai-Hwan PARK; Yong-Jin CHO; Jong-Moo PARK; Kyusik KANG; Kyung-Bok LEE; Soo-Joo LEE; Jae-Guk KIM; Jun LEE; Man-Seok PARK; Kang-Ho CHOI; Joon-Tae KIM; Kyung-Ho YU; Byung-Chul LEE; Mi-Sun OH; Jae-Kwan CHA; Dae-Hyun KIM; Hyun-Wook NAH; Dong-Eog KIM; Wi-Sun RYU; Beom-Joon KIM; Hee-Joon BAE; Wook-Joo KIM; Dong-Ick SHIN; Min-Ju YEO; Sung-Il SOHN; Jeong-Ho HONG; Juneyoung LEE; Keun-Sik HONG.
Journal of Stroke
; : 344-351, 2016.
Artículo
en Inglés
| WPRIM | ID: wpr-9523
BACKGROUND AND
PURPOSE:
About 30%-40% of stroke patients are taking antiplatelet at the time of their strokes, which might increase the risk of symptomatic intracranial hemorrhage (SICH) with intravenous tissue plasminogen activator (IV-TPA) therapy. We aimed to assess the effect of prestroke antiplatelet on the SICH risk and functional outcome in Koreans treated with IV-TPA.METHODS:
From a prospective stroke registry, we identified patients treated with IV-TPA between October 2009 and November 2014. Prestroke antiplatelet use was defined as taking antiplatelet within 7 days before the stroke onset. The primary outcome was SICH. Secondary outcomes were discharge modified Rankin Scale (mRS) score and in-hospital mortality.RESULTS:
Of 1,715 patients treated with IV-TPA, 441 (25.7%) were on prestroke antiplatelet. Prestroke antiplatelet users versus non-users were more likely to be older, to have multiple vascular risk factors. Prestroke antiplatelet use was associated with an increased risk of SICH (5.9% vs. 3.0%; adjusted odds ratio [OR] 1.79 [1.05-3.04]). However, at discharge, the two groups did not differ in mRS distribution (adjusted OR 0.90 [0.72-1.14]), mRS 0-1 outcome (34.2% vs. 33.7%; adjusted OR 1.27 [0.94-1.72), mRS 0-2 outcome (52.4% vs. 52.9%; adjusted OR 1.21 [0.90-1.63]), and in-hospital mortality (6.1% vs. 4.2%; adjusted OR 1.19 [0.71-2.01]).CONCLUSIONS:
Despite an increased risk of SICH, prestroke antiplatelet users compared to non-users had comparable functional outcomes and in-hospital mortality with IV-TPA therapy. Our results support the use of IV-TPA in eligible patients taking antiplatelet therapy before their stroke onset.
Biblioteca responsable:
WPRO
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