[The efficacy of systemic thrombolysis in patients with cardioembolic stroke]. / Éffektivnost' sistemnoi tromboliticheskoi terapii u bol'nykh s kardioémbolicheskim insul'tom.

AIM: To compare the efficacy and safety of systemic thrombolytic therapy (STLT) in patients with cardioembolic stroke (CE) versus other pathogenic subtypes of ischemic stroke (IS). MATERIAL AND METHODS: The study included 147 patients, 62 women and 85 men (mean age - 62.9±0.8 years) including 37 patients (25.2%) with CE subtype of IS (group 1) and 110 patients with other pathogenetic subtypes of IS (group 2). NIHSS and Rankin scale were used to assess patient's neurological status. RESULTS: One hundred and twenty-six patients were discharged, 21 (14.3%) died. In 11 patients, the cause of death was the development of symptomatic hemorrhagic transformation (SHT). There were no significant differences in the lethality between groups 1 and 2. Tolerability to STLT in these groups did not differ as well. As a result of treatment, the condition of patients surviving to the end of the hospital stay improved, which was reflected in a significant decrease in the NIHSS scores, despite the higher NIHSS scores in group 1. CONCLUSION: The results confirm the efficacy of STLT in patients with CE IS and indicate the increase in the frequency of favorable functional recovery in these patients.

[Systemic thrombolytic therapy of ischemic stroke in diabetes mellitus type 2 and hyperglycemia]. / Sistemnaya tromboliticheskaya terapiya ishemicheskogo insul'ta pri sakharnom diabete i giperglikemii.

AIM: Systemic thrombolytic therapy (STLT) is an available method of treatment of ischemic stroke (II) with proven efficacy. The efficacy and safety of STLT in certain groups of patients, in particular with diabetes mellitus type 2 (T2DM), are being discussed. To compare the efficacy and safety of STLC in II patients with T2DM, hyperglycemia and normoglycemia. MATERIAL AND METHODS: Eighty-six patients were examined, including 23 with T2DM (7 newly diagnosed), 27 with hyperglycemia at stroke onset and 36 with normoglycemia. Cardioembolic subtype of II was diagnosed in 35%, atherothrombotic in 29%, lacunar in 7%. In other patients, the subtype was unknown. STLT was administered to all patients 153.8±4.7 min after stroke onset. RESULTS: At admission, the NIHSS severity of II and the level disability assessed by the Rankin scale did not differ in the three groups. A significantly lower regression was observed in patients with T2DM (p<0.01) in the 28th day. The fatality was higher in this group compared to the patients with normoglycemia (p<0.05). The frequency of symptomatic hemorrhagic transformation (SHT) was higher (56.5%) as well. After treatment, status of surviving patients in all groups has improved to the end of hospitalization, which was reflected in a significant decrease in NIHSS compared to baseline (p<0.01). CONCLUSION: The data indicate an increased risk of SGT after STLC in patients with T2DM. Significant positive changes in the surviving patients with T2DM confirm the feasibility of STLC in patients with T2DM.