open access

Vol 52, No 5 (2018)
Original research articles
Submitted: 2018-03-25
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Cerebral thrombolysis in patients with ischemic stroke and heart failure

Piotr Sobolewski, Grzegorz Kozera, Wiktor Szczuchniak, Anna Sobota, Kamil Chwojnicki, Marcin Gruchała, Walenty M. Nyka
DOI: 10.1016/j.pjnns.2018.08.003
·
Neurol Neurochir Pol 2018;52(5):593-598.

open access

Vol 52, No 5 (2018)
Original research articles
Submitted: 2018-03-25

Abstract

Background

Heart failure (HF) is common among patients with ischemic stroke (IS), however its impact on outcome after iv-thrombolysis has not been fully determined. Moreover, definition of HF has been recently modified, but majority of stroke studies classified patients regarding an old HF criteria. Thus, the aim of our study was to evaluate the relationship between both, newly and formerly defined HF and the long-term outcome, mortality and the presence of hemorrhagic complications in patients with acute IS treated with iv-thrombolysis.

Methods

We retrospectively evaluated data from 328 Caucasian patients with IS consecutively treated with iv-thrombolysis. HF was defined according to old and new definition; long-term outcome was assessed with modified Rankin Scale (mRS) score and mortality rate on 90th days after IS.

Results

The incidence of HF did not differ between patients with favorable (mRS 0–2) and unfavorable (mRS 3–6) functional outcome respectively for the old and for the new definition (10.4% vs. 15.5, p = 0.17; 17.4% vs. 18.1%, p = 0.88) and between those who survived and died within 90 days after IS (11.7% vs. 20.0%, p = 0.27; 17.2% vs. 25.0%, p = 0.38, respectively). Multivariate analysis showed no impact of HF diagnosis on outcome (p = 0.94) or mortality (p = 0.64).

Conclusion

The presence of systolic HF, defined according to an old and a new definition, does not determine safety and efficacy of cerebral iv-thrombolysis in patients with IS.

Abstract

Background

Heart failure (HF) is common among patients with ischemic stroke (IS), however its impact on outcome after iv-thrombolysis has not been fully determined. Moreover, definition of HF has been recently modified, but majority of stroke studies classified patients regarding an old HF criteria. Thus, the aim of our study was to evaluate the relationship between both, newly and formerly defined HF and the long-term outcome, mortality and the presence of hemorrhagic complications in patients with acute IS treated with iv-thrombolysis.

Methods

We retrospectively evaluated data from 328 Caucasian patients with IS consecutively treated with iv-thrombolysis. HF was defined according to old and new definition; long-term outcome was assessed with modified Rankin Scale (mRS) score and mortality rate on 90th days after IS.

Results

The incidence of HF did not differ between patients with favorable (mRS 0–2) and unfavorable (mRS 3–6) functional outcome respectively for the old and for the new definition (10.4% vs. 15.5, p = 0.17; 17.4% vs. 18.1%, p = 0.88) and between those who survived and died within 90 days after IS (11.7% vs. 20.0%, p = 0.27; 17.2% vs. 25.0%, p = 0.38, respectively). Multivariate analysis showed no impact of HF diagnosis on outcome (p = 0.94) or mortality (p = 0.64).

Conclusion

The presence of systolic HF, defined according to an old and a new definition, does not determine safety and efficacy of cerebral iv-thrombolysis in patients with IS.

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Keywords

Alteplase, Heart failure definition, Ischemic stroke, iv-thrombolysis

About this article
Title

Cerebral thrombolysis in patients with ischemic stroke and heart failure

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 52, No 5 (2018)

Pages

593-598

DOI

10.1016/j.pjnns.2018.08.003

Bibliographic record

Neurol Neurochir Pol 2018;52(5):593-598.

Keywords

Alteplase
Heart failure definition
Ischemic stroke
iv-thrombolysis

Authors

Piotr Sobolewski
Grzegorz Kozera
Wiktor Szczuchniak
Anna Sobota
Kamil Chwojnicki
Marcin Gruchała
Walenty M. Nyka

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