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Stroke severity modified the effect of chronic atrial fibrillation on the outcome of thrombolytic therapy
This study was designed to identify high-risk patients with chronic AF who had undergone thrombolysis treatment and to explore whether the baseline National Institutes of Health Stroke Scale (NIHSS) could be used to distinguish poor clinical outcomes in thrombolyzed patients.
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Efficacy and safety of rt-PA intravenous thrombolysis in patients with wake-up stroke: A meta-analysis
Background : Recombinant tissue plasminogen activator (rt-PA) is one of the most effective therapies for patients with acute ischemic stroke. However, wake-up stroke (WUS) is typically excluded from intravenous thrombolytic therapy because of the unclear time of symptom onset. Therefore, we aimed to assess the efficacy and safety of rt-PA intravenous thrombolysis in patients with WUS by meta-analysis. Methods : We completed a systematic literature search of PubMed, Embase, the Cochrane Library, and SinoMed and included relevant studies of WUS patients covering rt-PA thrombolysis and nonthrombolysis (published fr...
Source: Medicine - February 18, 2022 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke
This study was performed to determine whether red blood cell distribution width (RDW) is associated with 3-month poor functional outcome in patients undergoing thrombolytic therapy for acute ischemic stroke. RDW was measured in patients with thrombolytic therapy in emergency department. Functional outcome was assessed after 3 months and poor functional outcome was defined as modified Rankin scale 3 to 6. A total of 240 patients were enrolled, and 82 (34.2%) had a poor functional outcome. The median RDW was significantly elevated in patients with a poor functional outcome compare with those with a good outcome. RDW ...
Source: Medicine - September 17, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Chinese herbal injections combined with rt-PA intravenous thrombolysis for acute ischemic stroke: A systematic review and meta-analysis protocol
Conclusion: The conclusion of the meta-analysis will provide a basis for judging whether CHIs combined with intravenous thrombolysis is an effective measure for the treatment of AIS. Ethics and dissemination: Ethical approval is not needed because this study will be based on data that already published. We will publish the findings of this study in a peer-reviewed journal and related conferences. PROSPERO registration number: CRD42020215546.
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Effectiveness and safety of different doses of tenecteplase in the treatment of acute ischemic stroke: A protocol for systematic review and meta-analysis
Conclusion: This study will provide reliable evidence-based evidence for the clinical application of different doses of tenecteplase in thrombolytic therapy for acute ischemic stroke. OSF Registration number: DOI 10.17605/OSF.IO/2MPCW.
Source: Medicine - January 22, 2021 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Efficacy and safety of intravenous thrombolysis with alteplase for treating acute ischemic stroke at different time windows: A protocol for systematic review and meta-analysis
Conclusions: This study will provide an evidence-based basis for the clinical efficacy of alteplase for treating AIS by thrombolytic therapy at different time windows. Ethics and dissemination: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF Registration number: DOI 10.17605 / OSF.IO / K7PHB
Source: Medicine - December 24, 2020 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man: A case report
Conclusion: VAD should be taken into consideration in differential diagnosis of posterior circulation stroke or transient ischemic attack in young patients. Intravenous thrombolytic therapy may be safe and effective for stroke-complicated cases. This case report demonstrates that expanded diagnostic protocol for acute ischemic stroke assures rapid and correct diagnosis.
Source: Medicine - October 29, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Clinical efficacy and imaging evaluation of recombinant tissue plasminogen activator thrombolytic therapy in patients with wake up stroke: A randomized controlled trial
This study will be a single-blinded, randomized controlled trial with 2 parallel groups. It will be conducted at North China University of science and technology affiliated hospital. Discussion: There is no consistent conclusion about the pathogenesis of wake up stroke. Wake up stroke is more likely to manifest as small vessel disease. The incidence of wake up stroke patients is relatively high, and the effectiveness and safety of intravenous thrombolysis under the guidance of multimode imaging therapy in wake up stroke need to be further explored by prospective, large-scale studies. Trial registration: ClinicalTrial...
Source: Medicine - September 4, 2020 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Similar thrombolysis outcomes in acute stroke patients with and without atrial fibrillation if pre-stroke CHA2DS2-VASc score is low: A retrospective study
The prognosis of acute ischemic stroke patients treated with intravenous (IV) recombinant tissue plasminogen activator (rtPA) is poorer in patients with atrial fibrillation (AF) than patients without AF, which might be related to the greater stroke severity in AF patients. Higher pre-stroke CHA2DS2-VASc scores are associated with greater stroke severity and poorer outcomes. AF Patients tend to have higher CHA2DS2-VASc scores than the non-AF patients. We thus hypothesized that pre-stroke CHA2DS2-VASc scores can be used to improve outcome stratification of IV thrombolysis therapy in acute stroke patients with and without AF....
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Early ST-segment elevation acute myocardial infarction after thrombolytic therapy for acute ischemic stroke: A case report
We report a case of STEMI occurring 40 minutes after thrombolytic therapy for AIS and discuss the possible mechanisms and therapeutic approaches. Patient concerns: A 87-year-old woman with a history of arterial hypertension was admitted for acute onset of right-sided limb weakness 2 hours before arrival at the emergency department. Forty minutes after intravenous recombinant tissue plasminogen activator (i.v. rtPA) administration for AIS, STEMI occurred (signaled by a third-degree atrioventricular block). Diagnoses: The diagnoses were AIS and STEMI. Coronary angiography confirmed right coronary artery occlusion. ...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Low free triiodothyronine levels predict symptomatic intracranial hemorrhage and worse short-term outcome of thrombolysis in patients with acute ischemia stroke
Abstract The aim of the study was to determine whether thyroid hormones level on admission in patients with ischemic stroke, treated with intravenous recombinant tissue type plasminogen activator (rtPA), was associated with symptomatic intracranial hemorrhage (sICH) and worse outcomes at 3 months. Patients with acute ischemic stroke (AIS) receiving intravenous rtPA thrombolytic treatment on our stroke unit between January 2015 and June 2016 were included in this study. Serum-free triiodothyronine (fT3), free thyroxine (fT4), total triiodothyronine (tT3), total thyroxine (tT4), and thyroid-stimulating hormone (TSH) were ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The Relationships Among Regionalization, Processes, and Outcomes for Stroke Care: A Nationwide Population-based Study
We examined the association of regionalization with processes and outcomes, and the mediating effect of processes of care on the association between regionalization and mortality for acute stroke in Taiwan. We analyzed all 229,568 admissions with acute ischemic stroke from January 2004 to September 2012 through Taiwan's National Health Insurance Research Database. Regionalized care for acute stroke has been implemented since July 2009 in Taiwan. Rates of thrombolytic therapy within 3 hours after onset of ischemic stroke, average numbers of processes of care, and 30-day mortality rates at monthly intervals for baseline...
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Renal Dysfunction and Thrombolytic Therapy in Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
This study aimed to evaluate the safety and effectiveness of thrombolytic therapy in acute stroke patients with renal dysfunction using a meta-analysis. We systematically searched PubMed and EMBASE for studies that evaluated the relationship between renal dysfunction and intravenous tissue plasminogen activator (tPA) in patients with acute ischemic stroke. Poor outcome (modified Rankin Scale ≥2), mortality, and symptomatic intracranial hemorrhage (ICH) and any ICH were analyzed. Fourteen studies were included (N = 53,553 patients). The mean age ranged from 66 to 75 years. The proportion of male participants was 49% t...
Source: Medicine - December 1, 2014 Category: Internal Medicine Tags: Article: Systematic Review and Meta-Analysis Source Type: research