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@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, vol.~264, No~5, p.~912-920. ISSN~0340-5354. doi:10.1007/s00415-017-8461-8. 2017.
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