BACKGROUND AND PURPOSE: Atrial fibrillation (AF) is a predictor for severe stroke. Intravenous administration of tissue plasminogen activator (t-PA) can improve clinical outcomes in patients with acute ischemic stroke. We investigated clinical characteristics and patient outcome in patients with and without AF after t-PA therapy. METHODS: Consecutive ischemic stroke patients treated with t-PA within 3 h of stroke onset were studied prospectively. MRI examinations, including diffusion weighted imaging and MRA, were performed before t-PA thrombolysis. NIHSS scores were obtained before and 7 days after t-PA infusion. The patients were divided into two groups (AF group and Non-AF group). Their clinical characteristics and outcome 7 days and 3 months after t-PA therapy were compared. RESULTS: 85 patients (56 males, mean age, 73.4+/-11.5 years) were enrolled in the present study. The AF-group had 44 patients, and the Non-AF group had 41 patients. Fewer patients with AF had dramatic improvement at 7 days and favorable outcome (mRS 0-1) at 3 months after t-PA therapy than patients without AF (31.8% vs. 61.0%, P=0.007, and 15.9% vs. 46.3%, P=0.002). On the other hand, worsening at 7 days and poor outcome (mRS >3 and death) at 3 months after t-PA therapy were more frequently observed in AF group than Non-AF group (22.7% vs. 9.8%, P=0.107, and 70.5% vs. 41.5%, P=0.007). After adjusting age and gender, patients with AF more frequently had worsening and poor outcome than those without AF (adjusted OR; 4.54, 95% CI 1.04-19.75, P=0.044, and adjusted OR; 2.8, 95% CI 1.10-7.28, P=0.032). CONCLUSION: The present study found that acute ischemic stroke patients with AF more frequently had poor outcome after IV-t-PA therapy compared with those without AF.
BACKGROUND AND PURPOSE:Atrial fibrillation (AF) is a predictor for severe stroke. Intravenous administration of tissue plasminogen activator (t-PA) can improve clinical outcomes in patients with acute ischemic stroke. We investigated clinical characteristics and patient outcome in patients with and without AF after t-PA therapy. METHODS: Consecutive ischemic strokepatients treated with t-PA within 3 h of stroke onset were studied prospectively. MRI examinations, including diffusion weighted imaging and MRA, were performed before t-PA thrombolysis. NIHSS scores were obtained before and 7 days after t-PA infusion. The patients were divided into two groups (AF group and Non-AF group). Their clinical characteristics and outcome 7 days and 3 months after t-PA therapy were compared. RESULTS: 85 patients (56 males, mean age, 73.4+/-11.5 years) were enrolled in the present study. The AF-group had 44 patients, and the Non-AF group had 41 patients. Fewer patients with AF had dramatic improvement at 7 days and favorable outcome (mRS 0-1) at 3 months after t-PA therapy than patients without AF (31.8% vs. 61.0%, P=0.007, and 15.9% vs. 46.3%, P=0.002). On the other hand, worsening at 7 days and poor outcome (mRS >3 and death) at 3 months after t-PA therapy were more frequently observed in AF group than Non-AF group (22.7% vs. 9.8%, P=0.107, and 70.5% vs. 41.5%, P=0.007). After adjusting age and gender, patients with AF more frequently had worsening and poor outcome than those without AF (adjusted OR; 4.54, 95% CI 1.04-19.75, P=0.044, and adjusted OR; 2.8, 95% CI 1.10-7.28, P=0.032). CONCLUSION: The present study found that acute ischemic strokepatients with AF more frequently had poor outcome after IV-t-PA therapy compared with those without AF.
Authors: Adnan I Qureshi; Foad Abd-Allah; Aitziber Aleu; John J Connors; Ricardo A Hanel; Ameer E Hassan; Haitham M Hussein; Nazli A Janjua; Rakesh Khatri; Jawad F Kirmani; Mikael Mazighi; Heinrich P Mattle; Jefferson T Miley; Thanh N Nguyen; Gustavo J Rodriguez; Qaisar A Shah; Adnan H Siddiqui; Jose I Suarez; M Fareed K Suri; Reha Tolun Journal: J Vasc Interv Neurol Date: 2014-05
Authors: Daniel Sanák; Roman Herzig; Michal Král; Andrea Bártková; Jana Zapletalová; Martin Hutyra; David Skoloudík; Ivanka Vlachová; Tomás Veverka; David Horák; Petr Kanovský Journal: J Neurol Date: 2010-02-02 Impact factor: 4.849