Title :

Intravenous Thrombolysis 4.5-9 Hours After Stroke Onset - a Cohort Study from the TRISP Collaboration.

Author(s) :

Altersberger, V. L. [Auteur]
Sibolt, G. [Auteur]
Enz, L. S. [Auteur]
Hametner, C. [Auteur]
Scheitz, J. F. [Auteur]
Henon, Hilde [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Bigliardi, G. [Auteur]
Strambo, D. [Auteur]
Martinez-Majander, N. [Auteur]
Stolze, L. J. [Auteur]
Heldner, M. R. [Auteur]
Grisendi, I. [Auteur]
Jovanovic, D. R. [Auteur]
Bejot, Y. [Auteur]
Pezzini, A. [Auteur]
Leker, R. R. [Auteur]
Kägi, G. [Auteur]
Wegener, S. [Auteur]
Cereda, C. W. [Auteur]
Ntaios, G. [Auteur]
De Marchis, G. M. [Auteur]
Bonati, L. H. [Auteur]
Psychogios, M. [Auteur]
Lyrer, P. [Auteur]
Räty, S. [Auteur]
Tiainen, M. [Auteur]
Wouters, A. [Auteur]
Caparros, F. [Auteur]
Heyse, M. [Auteur]
Erdur, H. [Auteur]
Padjen, V. [Auteur]
Zedde, M. [Auteur]
Arnold, M. [Auteur]
Nederkoorn, P. J. [Auteur]
Michel, P. [Auteur]
Zini, A. [Auteur]
Cordonnier, Charlotte [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Nolte, C. H. [Auteur]
Ringleb, P. A. [Auteur]
Curtze, S. [Auteur]
Engelter, S. T. [Auteur]
Gensicke, H. [Auteur]
Université de Bâle = University of Basel = Basel Universität [Unibas]

Journal title :

Annals of Neurology

Volume number :

94

Pages :

309-320

Publisher :

Wiley Online Library

Publication date :

2023-04-29

ISSN :

1531-8249

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective To investigate the safety and effectiveness of intravenous thrombolysis (IVT) >4.5–9 hours after stroke onset, and the relevance of advanced neuroimaging for patient selection. Methods Prospective multicenter ...
Show more >Objective To investigate the safety and effectiveness of intravenous thrombolysis (IVT) >4.5–9 hours after stroke onset, and the relevance of advanced neuroimaging for patient selection. Methods Prospective multicenter cohort study from the ThRombolysis in Ischemic Stroke Patients (TRISP) collaboration. Outcomes were symptomatic intracranial hemorrhage, poor 3-month functional outcome (modified Rankin scale 3–6) and mortality. We compared: (i) IVT >4.5–9 hours versus 0–4.5 hours after stroke onset and (ii) within the >4.5–9 hours group baseline advanced neuroimaging (computed tomography perfusion, magnetic resonance perfusion or magnetic resonance diffusion-weighted imaging fluid-attenuated inversion recovery) versus non-advanced neuroimaging. Results Of 15,827 patients, 663 (4.2%) received IVT >4.5–9 hours and 15,164 (95.8%) within 4.5 hours after stroke onset. The main baseline characteristics were evenly distributed between both groups. Time of stroke onset was known in 74.9% of patients treated between >4.5 and 9 hours. Using propensity score weighted binary logistic regression analysis (onset-to-treatment time >4.5–9 hours vs onset-to-treatment time 0–4.5 hours), the probability of symptomatic intracranial hemorrhage (ORadjusted 0.80, 95% CI 0.53–1.17), poor functional outcome (ORadjusted 1.01, 95% CI 0.83–1.22), and mortality (ORadjusted 0.80, 95% CI 0.61–1.04) did not differ significantly between both groups. In patients treated between >4.5 and 9 hours, the use of advanced neuroimaging was associated with a 50% lower mortality compared with non-advanced imaging only (9.9% vs 19.7%; ORadjusted 0.51, 95% CI 0.33–0.79). Interpretation This study showed no evidence in difference of symptomatic intracranial hemorrhage, poor outcome, and mortality in selected stroke patients treated with IVT between >4.5 and 9 hours after stroke onset compared with those treated within 4.5 hours. Advanced neuroimaging for patient selection was associated with lower mortality.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Submission date :

2024-01-15T23:03:35Z
2024-09-25T09:08:43Z