Postthrombolytic Antiplatelet Use for Patients with Intercerebral Hemorrhage without Extensive Parenchymal Involvement Does Not Worsen Outcome.
10.3988/jcn.2015.11.4.305
- Author:
Weihua JIA
1
;
Lichun ZHOU
;
Xiaoling LIAO
;
Yuesong PAN
;
Yongjun WANG
Author Information
1. Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. yongjunwang1962@gmail.com
- Publication Type:Original Article
- Keywords:
ischemic stroke;
thrombolytic-related hemorrhage;
antiplatelet therapy;
outcome
- MeSH:
Cerebral Hemorrhage;
China;
Hemorrhage*;
Humans;
Logistic Models;
Mortality;
National Institutes of Health (U.S.);
Recurrence;
Stroke
- From:Journal of Clinical Neurology
2015;11(4):305-310
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: It is unclear whether postthrombolytic antiplatelet (AP) therapy after thrombolytic-related hemorrhage without extensive parenchymal involvement (THEPI) affects the clinical outcome. This study explored whether AP administration in patients with THEPI affects short- and long-term outcomes. METHODS: All of the data for this study were collected from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) registry. Patients with THEPI were assigned to either the AP (AP therapy should be commenced 24 h after intravenous thrombolysis) or AP-naive groups. THEPI was defined according to European-Australasian Acute Stroke Study II criteria. The 90-day functional outcome, 7-day National Institutes of Health Stroke Scale (NIHSS) score, and 7-day and 90-day mortalities were compared between the AP and AP-naive groups. Logistic regression analysis was used to evaluate the effects of AP therapy on the short- and long-term clinical outcomes. RESULTS: Of the 928 patients enrolled from those in the TIMS-China registry (n=1,440), 89 (9.6%) had nonsymptomatic intracerebral hemorrhage (ICH) within 24-36 h after thrombolysis; 33 (37%) of these patients were given AP therapy (AP group) and 56 (63%) were not (AP-naive group). No significant differences were found for the risk of 7-day aggravated ICH (p=0.998), 7-day NIHSS score (p=0.5491), 7-day mortality [odds ratio (OR)=3.427; 95% confidence interval (95% CI)=0.344-34.160; p=0.294], 90-day mortality (OR=0.788, 95% CI=0.154-4.040, p=0.775), or modified Rankin score 5 or 6 at 90-days (OR=1.108, 95% CI=0.249-4.928, p=0.893) between the AP and AP-naive groups after THEPI. CONCLUSIONS: Early administration of postthrombolytic AP therapy after THEPI does not worsen either the short- or long-term outcome. AP therapy may be a reasonable treatment option for patients with THEPI to reduce the risk of ischemic stroke recurrence.
