Intravenous thrombolysis associated with a high risk of hemorrhagic transformation in ischemicstroke patients with cardiac myxoma and over 70 years of age
- Author:
Cheung-Ter Ong
- Publication Type:Journal Article
- From:Neurology Asia
2012;17(3):193-197
- CountryMalaysia
- Language:English
-
Abstract:
Objectives: Although thrombolytic therapy has been shown to be benefi cial to stroke patients, its
safety and effectiveness in stroke patients with cardiac tumor is unknown. This study assessed the
safety and effi cacy of intravenous thrombolysis with recombinant-tissue plasminogen activator (rtPa)
in stroke patients with cardiac myxoma. Methods: We systematically searched databases for
all publications on thrombolysis in patients with cardiac tumor-related strokes. The literature on
thrombolysis in ischemic stroke patients with myxoma was systematically analyzed; information on
the hemorrhagic transformation and response rates in patients over and under 70 years of age was
extracted and compared. Statistical tests were performed to evaluate the odds ratios for these factors.
Results: Twelve case reports were identifi ed. Four patients were 70 years of age or older, two (50%)
of whom had demonstrated hemorrhagic transformation, which was not found in patients under 60
years of age. The rate of response to treatment was 60% (3/5) in patients under 60 and 25% (1/4) in
those ≥70 years of age. The rate of hemorrhagic transformation in the patients ≥70 years of age was
higher than that in patients <70 years of age (odds ratio 7).
Conclusion: Intravenous thrombolysis in ischemic stroke patients with myxoma who were over 70 years
of age was associated with a lower response rate and a higher risk of hemorrhagic transformation.
- Full text:P020150710487489403089.pdf
