Intravenous thrombolysis for ischemic stroke in the golden
hour: propensity-matched analysis from the SITS-EAST registry

J 2017

Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry

TSIVGOULIS, G., A.H. KATSANOS, P. KADLECOVA, A. CZLONKOWSKA, A. KOBAYASHI et. al.

Basic information

Original name

Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry

Authors

TSIVGOULIS, G. (300 Greece), A.H. KATSANOS (300 Greece), P. KADLECOVA (203 Czech Republic), A. CZLONKOWSKA (616 Poland), A. KOBAYASHI (616 Poland), M. BROZMAN (703 Slovakia), V. SVIGELJ (705 Slovenia), L. CSIBA (348 Hungary), K. FEKETE (233 Estonia), J. KORV (233 Estonia), V. DEMARIN (191 Croatia), A. VILIONSKIS (440 Lithuania), D. JATUZIS (440 Lithuania), Y. KRESPI (792 Turkey), C. LIANTINIOTI (300 Greece), S. GIANNOPOULOS (300 Greece) and Robert MIKULÍK (203 Czech Republic, guarantor, belonging to the institution)

Edition

European Journal of Neurology, HEIDELBERG, SPRINGER HEIDELBERG, 2017, 0340-5354

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.783

RIV identification code

RIV/00216224:14110/17:00100262

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00415-017-8461-8

UT WoS

000400617200011

Keywords in English

Intravenous thrombolysis; Acute ischemic stroke; Golden hour; Onset-to-treatment time; Mobile stroke unit

Abstract

V originále

As there are scarce data regarding the outcomes of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) within 60 min from symptom onset ("golden hour"), we sought to compare outcomes between AIS patients treated within [GH(+)] and outside [GH(-)] the "golden hour" by analyzing propensity score matched data from the SITS-EAST registry. Clinical recovery (CR) at 2 and 24 h was defined as a reduction of ae10 points on NIHSS-score or a total NIHSS-score of ae3 at 2 and 24 h, respectively. A relative reduction in NIHSS-score of ae40% at 2 h was considered predictive of complete recanalization (CREC). Symptomatic intracranial hemorrhage (sICH) was defined using SITS-MOST criteria. Favorable functional outcome (FFO) was defined as a mRS-score of 0-1 at 3 months. Out of 19,077 IVT-treated AIS patients, 71 GH(+) patients were matched to 6882 GH(-) patients, with no differences in baseline characteristics (p > 0.1). GH(+) had higher rates of CR at 2 (31.0 vs. 12.4%; p < 0.001) and 24 h (41 vs. 27%; p = 0.010), CREC at 2 h (39 vs. 21%; p < 0.001) and FFO (46.5 vs. 34.0%; p = 0.028) at 3 months. The rates of sICH and 3-month mortality did not differ (p > 0.2) between the two groups. GH(+) was associated with 2-h CR (OR: 5.34; 95% CI 2.53-11.03) and CREC (OR: 2.38; 95% CI 1.38-4.09), 24-h CR (OR: 1.88; 95% CI 1.08-3.26) and 3-month FFO (OR: 2.02; 95% CI 1.15-3.54) in multivariable logistic regression models adjusting for potential confounders. In conclusion, AIS treated with IVT within the GH seems to have substantially higher odds of early neurological recovery, CREC, 3-month FFO and functional improvement.

Citovat

TSIVGOULIS, G., A.H. KATSANOS, P. KADLECOVA, A. CZLONKOWSKA, A. KOBAYASHI, M. BROZMAN, V. SVIGELJ, L. CSIBA, K. FEKETE, J. KORV, V. DEMARIN, A. VILIONSKIS, D. JATUZIS, Y. KRESPI, C. LIANTINIOTI, S. GIANNOPOULOS and Robert MIKULÍK. Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry. European Journal of Neurology. HEIDELBERG: SPRINGER HEIDELBERG, 2017, vol. 264, No 5, p. 912-920. ISSN 0340-5354. Available from: https://dx.doi.org/10.1007/s00415-017-8461-8.

@article{1410315,
   author = {Tsivgoulis, G. and Katsanos, A.H. and Kadlecova, P. and Czlonkowska, A. and Kobayashi, A. and Brozman, M. and Svigelj, V. and Csiba, L. and Fekete, K. and Korv, J. and Demarin, V. and Vilionskis, A. and Jatuzis, D. and Krespi, Y. and Liantinioti, C. and Giannopoulos, S. and Mikulík, Robert},
   article_location = {HEIDELBERG},
   article_number = {5},
   doi = {http://dx.doi.org/10.1007/s00415-017-8461-8},
   keywords = {Intravenous thrombolysis; Acute ischemic stroke; Golden hour; Onset-to-treatment time; Mobile stroke unit},
   language = {eng},
   issn = {0340-5354},
   journal = {European Journal of Neurology},
   title = {Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry},
   volume = {264},
   year = {2017}
}

TY  - JOUR
ID  - 1410315
AU  - Tsivgoulis, G. - Katsanos, A.H. - Kadlecova, P. - Czlonkowska, A. - Kobayashi, A. - Brozman, M. - Svigelj, V. - Csiba, L. - Fekete, K. - Korv, J. - Demarin, V. - Vilionskis, A. - Jatuzis, D. - Krespi, Y. - Liantinioti, C. - Giannopoulos, S. - Mikulík, Robert
PY  - 2017
TI  - Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry
JF  - European Journal of Neurology
VL  - 264
IS  - 5
SP  - 912-920
EP  - 912-920
PB  - SPRINGER HEIDELBERG
SN  - 03405354
KW  - Intravenous thrombolysis
KW  - Acute ischemic stroke
KW  - Golden hour
KW  - Onset-to-treatment time
KW  - Mobile stroke unit
N2  - As there are scarce data regarding the outcomes of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) within 60 min from symptom onset ("golden hour"), we sought to compare outcomes between AIS patients treated within [GH(+)] and outside [GH(-)] the "golden hour" by analyzing propensity score matched data from the SITS-EAST registry. Clinical recovery (CR) at 2 and 24 h was defined as a reduction of ae10 points on NIHSS-score or a total NIHSS-score of ae3 at 2 and 24 h, respectively. A relative reduction in NIHSS-score of ae40% at 2 h was considered predictive of complete recanalization (CREC). Symptomatic intracranial hemorrhage (sICH) was defined using SITS-MOST criteria. Favorable functional outcome (FFO) was defined as a mRS-score of 0-1 at 3 months. Out of 19,077 IVT-treated AIS patients, 71 GH(+) patients were matched to 6882 GH(-) patients, with no differences in baseline characteristics (p > 0.1). GH(+) had higher rates of CR at 2 (31.0 vs. 12.4%; p < 0.001) and 24 h (41 vs. 27%; p = 0.010), CREC at 2 h (39 vs. 21%; p < 0.001) and FFO (46.5 vs. 34.0%; p = 0.028) at 3 months. The rates of sICH and 3-month mortality did not differ (p > 0.2) between the two groups. GH(+) was associated with 2-h CR (OR: 5.34; 95% CI 2.53-11.03) and CREC (OR: 2.38; 95% CI 1.38-4.09), 24-h CR (OR: 1.88; 95% CI 1.08-3.26) and 3-month FFO (OR: 2.02; 95% CI 1.15-3.54) in multivariable logistic regression models adjusting for potential confounders. In conclusion, AIS treated with IVT within the GH seems to have substantially higher odds of early neurological recovery, CREC, 3-month FFO and functional improvement.
ER  -

TSIVGOULIS, G., A.H. KATSANOS, P. KADLECOVA, A. CZLONKOWSKA, A. KOBAYASHI, M. BROZMAN, V. SVIGELJ, L. CSIBA, K. FEKETE, J. KORV, V. DEMARIN, A. VILIONSKIS, D. JATUZIS, Y. KRESPI, C. LIANTINIOTI, S. GIANNOPOULOS and Robert MIKULÍK. Intravenous thrombolysis for ischemic stroke in the golden hour: propensity-matched analysis from the SITS-EAST registry. \textit{European Journal of Neurology}. HEIDELBERG: SPRINGER HEIDELBERG, 2017, vol.~264, No~5, p.~912-920. ISSN~0340-5354. Available from: https://dx.doi.org/10.1007/s00415-017-8461-8.

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