Should we exclude acute stroke patients with previous intracerebral hemorrhage from receiving intravenous thrombolysis?

被引：9

作者：

Lee, Sang-Hwa ^{[1
]}

Kim, Beom Joon ^{[2
]}

Han, Moon-Ku ^{[2
]}

Park, Tai Hwan ^{[3
]}

Lee, Kyung Bok ^{[4
]}

Lee, Byung-Chul ^{[5
]}

Yu, Kyung-Ho ^{[5
]}

Oh, Mi Sun ^{[5
]}

Cha, Jae Kwan ^{[6
]}

Kim, Dae-Hyun ^{[6
]}

Nah, Hyun-Wook ^{[6
]}

Lee, Jun ^{[7
]}

Lee, Soo Joo ^{[8
]}

Ko, Youngchai ^{[8
]}

Kim, Jae Guk ^{[8
]}

Park, Jong-Moo ^{[9
]}

Kang, Kyusik ^{[9
]}

Cho, Yong-Jin ^{[10
]}

Hong, Keun-Sik ^{[10
]}

Choi, Jay Chol ^{[11
]}

Kim, Joon-Tae ^{[12
]}

Choi, Kangho ^{[12
]}

Kim, Dong-Eog ^{[13
]}

Ryu, Wi-Sun ^{[13
]}

Kim, Wook-Joo ^{[14
]}

Shin, Dong-Ick ^{[15
]}

Yeo, Minju ^{[15
]}

Lee, Juneyoung ^{[16
]}

Lee, Ji Sung ^{[17
]}

Gorelick, Philip B. ^{[18
,19
]}

Bae, Hee-Joon ^{[2
]}

机构：

[1] Kyung Hee Univ, Grad Sch, Dept Neurol, Seoul, South Korea

[2] Seoul Natl Univ, Bundang Hosp, Songnam, South Korea

[3] Seoul Med Ctr, Seoul, South Korea

[4] Soonchunhyang Univ Hosp, Seoul, South Korea

[5] Hallym Univ, Sacred Heart Hosp, Anyang, South Korea

[6] Dong A Univ Hosp, Pusan, South Korea

[7] Yeungnam Univ, Med Ctr, Daegu, South Korea

[8] Eulji Univ, Sch Med, Eulji Univ Hosp, Daejeon, South Korea

[9] Eulji Univ, Eulji Gen Hosp, Seoul, South Korea

[10] Inje Univ, Ilsan Paik Hosp, Goyang, South Korea

[11] Jeju Natl Univ, Jeju, South Korea

[12] Chonnam Natl Univ Hosp, Gwangju, South Korea

[13] Dongguk Univ, Ilsan Hosp, Goyang, South Korea

[14] Univ Ulsan, Coll Med, Ulsan Univ Hosp, Ulsan, South Korea

[15] Chungbuk Natl Univ, Coll Med, Cheongju, South Korea

[16] Korea Univ, Dept Biostat, Coll Med, Seoul, South Korea

[17] Asan Med Ctr, Clin Res Ctr, Seoul, South Korea

[18] Michigan State Univ, Dept Translat Sci & Mol Med, Coll Human Med, Grand Rapids, MI USA

[19] Mercy Hlth Hauenstein Neurosci, Grand Rapids, MI USA

来源：

INTERNATIONAL JOURNAL OF STROKE | 2016年 / 11卷 / 07期

关键词：

Acute ischemic stroke; history of intracerebral hemorrhage; brain macrobleed; intravenous thrombolysis; symptomatic hemorrhagic transformation; mortality; ACUTE ISCHEMIC-STROKE; TISSUE-PLASMINOGEN-ACTIVATOR; URGENT THERAPY; MULTICENTER; GUIDELINES; MANAGEMENT; REGISTRY; RISK;

D O I：

10.1177/1747493016654289

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background Current guidelines have contraindicated history of intracerebral hemorrhage for intravenous recombinant tissue plasminogen activator. Aim This study aimed to investigate the safety and effectiveness of intravenous recombinant tissue plasminogen activator for patients who had previous intracerebral hemorrhage on history or initial brain magnetic resonance imaging. Methods Using a prospective multicenter stroke registry database, we identified acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator within 4.5h of onset. Previous intracerebral hemorrhage was defined as having a clinical history or evidence of old intracerebral hemorrhage on initial brain magnetic resonance imaging. Associations of previous intracerebral hemorrhage with symptomatic hemorrhagic transformation during hospitalization and functional outcome and mortality at discharge and three months were analyzed. Results Among 1495 patients who were treated with intravenous recombinant tissue plasminogen activator, 73 (4.9%) had previous intracerebral hemorrhage; 9 on history only, 61 on magnetic resonance imaging only and 3 on both. Of those 1495 patients, 71 (4.7%) experienced symptomatic hemorrhagic transformation; 6.8% in patients with previous intracerebral hemorrhage and 4.6% in those without previous intracerebral hemorrhage. Multivariable logistic regression analysis showed that previous intracerebral hemorrhage did not significantly increase the risk of symptomatic hemorrhagic transformation (odds ratio 1.08, 95% confidence interval 0.39-2.96) mortality, and most of functional outcome measures Conclusions Previous intracerebral hemorrhage may neither increase the risk of symptomatic hemorrhagic transformation nor alter major clinical outcomes in acute ischemic stroke patients receiving intravenous recombinant tissue plasminogen activator. This study suggests reconsideration of prior history of intracerebral hemorrhage as an exclusion criterion for intravenous recombinant tissue plasminogen activator administration in acute ischemic stroke.

引用

页码：783 / 790

页数：8

共 28 条

[1] Implementation and outcome of thrombolysis with alteplase 3-4.5 h after an acute stroke: an updated analysis from SITS-ISTR [J].

Ahmed, Niaz ;

Wahlgren, Nils ;

Grond, Martin ;

Hennerici, Michael ;

Lees, Kennedy R. ;

Mikulik, Robert ;

Parsons, Mark ;

Roine, Risto O. ;

Toni, Danilo ;

Ringleb, Peter .

LANCET NEUROLOGY, 2010, 9 (09) :866-874

[2] Hemorrhagic complications after off-label thrombolysis for ischemic stroke [J].

Aleu, Aitziber ;

Mellado, Patricio ;

Lichy, Christoph ;

Koehrmann, Martin ;

Schellinger, Peter D. .

STROKE, 2007, 38 (02) :417-422

[3]

[Anonymous], 1995, NEW ENGL J MED, V333, P1581, DOI [10.1056/nejm199512143332401, DOI 10.1056/NEJM199512143332401]

[4] Risk of Intracerebral Hemorrhage After Thrombolysis in Patients with Asymptomatic Hemorrhage on T2 [J].

Aoki, Junya ;

Shibazaki, Kensaku ;

Saji, Naoki ;

Uemura, Junichi ;

Sakamoto, Yuki ;

Kimura, Kazumi .

CEREBROVASCULAR DISEASES, 2014, 38 (02) :107-116

[5] URGENT THERAPY FOR STROKE .1. PILOT-STUDY OF TISSUE PLASMINOGEN-ACTIVATOR ADMINISTERED WITHIN 90 MINUTES [J].

BROTT, TG ;

HALEY, EC ;

LEVY, DE ;

BARSAN, W ;

BRODERICK, J ;

SHEPPARD, GL ;

SPILKER, J ;

KONGABLE, GL ;

MASSEY, S ;

REED, R ;

MARLER, JR .

STROKE, 1992, 23 (05) :632-640

[6] Timeliness of Tissue-Type Plasminogen Activator Therapy in Acute Ischemic Stroke Patient Characteristics, Hospital Factors, and Outcomes Associated With Door-to-Needle Times Within 60 Minutes [J].

Fonarow, Gregg C. ;

Smith, Eric E. ;

Saver, Jeffrey L. ;

Reeves, Mathew J. ;

Bhatt, Deepak L. ;

Grau-Sepulveda, Maria V. ;

Olson, DaiWai M. ;

Hernandez, Adrian F. ;

Peterson, Eric D. ;

Schwamm, Lee H. .

CIRCULATION, 2011, 123 (07) :750-U184

[7]

Green Theresa, 2011, Can J Neurosci Nurs, V33, P4

[8] URGENT THERAPY FOR STROKE .2. PILOT-STUDY OF TISSUE PLASMINOGEN-ACTIVATOR ADMINISTERED 91-180 MINUTES FROM ONSET [J].

HALEY, EC ;

LEVY, DE ;

BROTT, TG ;

SHEPPARD, GL ;

WONG, MCW ;

KONGABLE, GL ;

TORNER, JC ;

MARLER, JR .

STROKE, 1992, 23 (05) :641-645

[9] Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [J].

Jauch, Edward C. ;

Saver, Jeffrey L. ;

Adams, Harold P., Jr. ;

Bruno, Askiel ;

Connors, J. J. ;

Demaerschalk, Bart M. ;

Khatri, Pooja ;

McMullan, Paul W., Jr. ;

Qureshi, Adnan I. ;

Rosenfield, Kenneth ;

Scott, Phillip A. ;

Summers, Debbie R. ;

Wang, David Z. ;

Wintermark, Max ;

Yonas, Howard .

STROKE, 2013, 44 (03) :870-947

[10] Imaging of intracranial haemorrhage [J].

Kidwell, Chelsea S. ;

Wintermark, Max .

LANCET NEUROLOGY, 2008, 7 (03) :256-267

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