Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article
Ischemic stroke subtype is associated with outcome in thrombolyzed patients. / Schmitz, Marie Louise; Simonsen, Claus Ziegler; Svendsen, M L; Larsson, Heidi Jeanet; Hjørringgaard Madsen, Mette; Mikkelsen, I K; Fisher, M; Johnsen, Søren Paaske; Andersen, Grethe.
In: Acta Neurologica Scandinavica. Supplementum, Vol. 135, No. 2, 02.2017, p. 176-182.Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article
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TY - JOUR
T1 - Ischemic stroke subtype is associated with outcome in thrombolyzed patients
AU - Schmitz,Marie Louise
AU - Simonsen,Claus Ziegler
AU - Svendsen,M L
AU - Larsson,Heidi Jeanet
AU - Hjørringgaard Madsen,Mette
AU - Mikkelsen,I K
AU - Fisher,M
AU - Johnsen,Søren Paaske
AU - Andersen,Grethe
N1 - © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2017/2
Y1 - 2017/2
N2 - OBJECTIVES: The impact of ischemic stroke subtype on clinical outcome in patients treated with intravenous tissue-type plasminogen activator (IV-tPA) is sparsely examined. We studied the association between stroke subtype and clinical outcome in magnetic resonance imaging (MRI)-evaluated patients treated with IV-tPA.MATERIAL AND METHODS: We conducted a single-center retrospective analysis of MRI-selected stroke patients treated with IV-tPA between 2004 and 2010. The Trial of ORG 10172 in Acute Stroke Treatment criteria were used to establish the stroke subtype by 3 months. The outcomes of interest were a 3-month modified Rankin Scale score of 0-1 (favorable outcome), and early neurological improvement defined as complete remission of neurological deficit or improvement of ≥4 on the National Institute of Health Stroke Scale at 24 h. The outcomes among stroke subtypes were compared with multivariable logistic regression.RESULTS:Among 557 patients, 202 (36%) had large vessel disease (LVD), 153 (27%) cardioembolic stroke (CE), 109 (20%) small vessel disease, and 93 (17%) were of other or undetermined etiology. Early neurological improvement was present in 313 (56.4%) patients, and 361 (64.8%) patients achieved a favorable outcome. Early neurological improvement and favorable outcome were more likely in CE patients compared with LVD patients (odds ratio (OR), 2.1 (95% confidence interval, 1.4-3.3), and 2.0 (95% confidence interval, 1.2-3.3), respectively).CONCLUSIONS: Cardioembolic stroke patients were more likely to achieve early neurological improvement and favorable outcome compared with LVD stroke following MRI-based IV-tPA treatment. This finding may reflect a difference in the effect of IV-tPA among stroke subtypes.
AB - OBJECTIVES: The impact of ischemic stroke subtype on clinical outcome in patients treated with intravenous tissue-type plasminogen activator (IV-tPA) is sparsely examined. We studied the association between stroke subtype and clinical outcome in magnetic resonance imaging (MRI)-evaluated patients treated with IV-tPA.MATERIAL AND METHODS: We conducted a single-center retrospective analysis of MRI-selected stroke patients treated with IV-tPA between 2004 and 2010. The Trial of ORG 10172 in Acute Stroke Treatment criteria were used to establish the stroke subtype by 3 months. The outcomes of interest were a 3-month modified Rankin Scale score of 0-1 (favorable outcome), and early neurological improvement defined as complete remission of neurological deficit or improvement of ≥4 on the National Institute of Health Stroke Scale at 24 h. The outcomes among stroke subtypes were compared with multivariable logistic regression.RESULTS:Among 557 patients, 202 (36%) had large vessel disease (LVD), 153 (27%) cardioembolic stroke (CE), 109 (20%) small vessel disease, and 93 (17%) were of other or undetermined etiology. Early neurological improvement was present in 313 (56.4%) patients, and 361 (64.8%) patients achieved a favorable outcome. Early neurological improvement and favorable outcome were more likely in CE patients compared with LVD patients (odds ratio (OR), 2.1 (95% confidence interval, 1.4-3.3), and 2.0 (95% confidence interval, 1.2-3.3), respectively).CONCLUSIONS: Cardioembolic stroke patients were more likely to achieve early neurological improvement and favorable outcome compared with LVD stroke following MRI-based IV-tPA treatment. This finding may reflect a difference in the effect of IV-tPA among stroke subtypes.
U2 - 10.1111/ane.12589
DO - 10.1111/ane.12589
M3 - Journal article
VL - 135
SP - 176
EP - 182
JO - Acta Neurologica Scandinavica. Supplementum
T2 - Acta Neurologica Scandinavica. Supplementum
JF - Acta Neurologica Scandinavica. Supplementum
SN - 0065-1427
IS - 2
ER -