Title :

Influence of on-going treatment with angiotensin-converting enzyme inhibitor or angiotensin receptor blocker on the outcome of patients treated with intravenous rt-PA for ischemic stroke.

Author(s) :

Gilliot, Sixtine [Auteur]
Sibon, Igor [Auteur]
Mas, Jean-Louis [Auteur]
Moulin, Thierry [Auteur]
Bejot, Yannick [Auteur]
Cordonnier, Charlotte [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Giroud, Maurice [Auteur]
Odou, Pascal [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - EA 7365
Bordet, Regis [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Vivien, Denis [Auteur]
LEYS, Didier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171

Journal title :

Journal of Neurology

Abbreviated title :

J. Neurol.

Volume number :

265

Pages :

1166-1173

Publication date :

2018-05-01

ISSN :

1432-1459

Keyword(s) :

Administration
Intravenous
Aged
Aged
80 and over
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Brain Ischemia
Female
Fibrinolytic Agents
Follow-Up Studies
Humans
Intracranial Hemorrhages
Male
Middle Aged
Prospective Studies
Recombinant Proteins
Stroke
Tissue Plasminogen Activator
Treatment Outcome
Cerebral ischemia
Hemorrhagic transformation
Ischemic stroke
Mechanical thrombectomy
Neuroprotection
Outcome
Thrombolysis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Many patients who receive intravenous (i.v.) recombinant tissue-plasminogen activator (rt-PA) for acute cerebral ischemia were under angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor ...
Show more >BACKGROUND: Many patients who receive intravenous (i.v.) recombinant tissue-plasminogen activator (rt-PA) for acute cerebral ischemia were under angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) at stroke onset. ACE-Is and ARBs have neuroprotective properties in animal models. OBJECTIVE: To evaluate whether the 3-month outcome of patients treated with i.v. rt-PA for cerebral ischemia was influenced by on-going therapy with ACE-Is or ARBs. METHOD: This study was observational, conducted in two prospective registries of stroke patients treated with i.v. rt-PA. We evaluated outcomes with the modified Rankin scale and symptomatic intracranial hemorrhages (s-ICH) according to the ECASS2 criteria. We compared outcomes between patients with and without ACE-Is/ARBs according to the modified Rankin scale (mRS) at month 3, using logistic regression analyses adjusted on propensity scores, and propensity-matched analyses. RESULTS: Of 1803 patients, 455 (25.2%) were under ACE-Is (259), ARBs (188) or both (8). At 3 months, patients under ACE-Is or ARBs were more likely to have an mRS 0-1, but did not differ for mRS 0-2, s-ICH and death. After adjustment on propensity scores, the association between ACE-Is/ARBs and mRS 0-1 disappeared. The propensity-matched analysis, performed in 397 pairs of patients, found no difference in outcomes between patients with and without ACE-Is or ARBs. CONCLUSION: In patients treated by intravenous thrombolytic therapy for ischemic stroke, on-going treatment with ACE-Is or ARBs does not influence on outcomes after adjustment on baseline characteristics and propensity scores.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille
CNRS
Inserm

Collections :

• Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - EA 7365
• Troubles cognitifs dégénératifs et vasculaires - U1171

Research team(s) :

Innovation/évaluation des médicaments injectables

Submission date :

2019-02-26T17:06:56Z