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Cerebral thrombolysis in patients with ischemic stroke and heart failure
open access
Abstract
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.
MethodsWe 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.
ResultsThe 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).
ConclusionThe 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
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.
MethodsWe 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.
ResultsThe 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).
ConclusionThe 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.
Keywords
Alteplase, Heart failure definition, Ischemic stroke, iv-thrombolysis
About this articleTitle
Cerebral thrombolysis in patients with ischemic stroke and heart failure
Journal
Neurologia i Neurochirurgia Polska
Issue
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