دورية أكاديمية
Safety and efficacy of intravenous thrombolysis in stroke patients on prior antiplatelet therapy in the WAKE-UP trial.
| العنوان: | Safety and efficacy of intravenous thrombolysis in stroke patients on prior antiplatelet therapy in the WAKE-UP trial. |
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| المؤلفون: | Frey, Benedikt M, Boutitie, Florent, Cheng, Bastian, Cho, Tae-Hee, Ebinger, Martin, Endres, Matthias, Fiebach, Jochen B, Fiehler, Jens, Ford, Ian, Galinovic, Ivana, Königsberg, Alina, Puig, Josep, Roy, Pascal, Wouters, Anke, Magnus, Tim, Thijs, Vincent, Lemmens, Robin, Muir, Keith W, Nighoghossian, Norbert, Pedraza, Salvador, Simonsen, Claus Z, Gerloff, Christian, Thomalla, Götz, WAKE-UP investigators, Vandermeeren, Yves |
| المساهمون: | UCL - SSS/IONS - Institute of NeuroScience, UCL - (MGD) Service de neurologie |
| المصدر: | Neurological research and practice, Vol. 2, p. 40 (2020) |
| سنة النشر: | 2020 |
| المجموعة: | DIAL@USL-B (Université Saint-Louis, Bruxelles) |
| مصطلحات موضوعية: | Alteplase, Antiplatelet, Aspirin, Clopidogrel, Hemorrhagic transformation, Ischemic stroke, Recombinant human tissue plasminogen activator, Rt-PA, Thrombolysis, WAKE UP |
| الوصف: | One quarter to one third of patients eligible for systemic thrombolysis are on antiplatelet therapy at presentation. In this study, we aimed to assess the safety and efficacy of intravenous thrombolysis in stroke patients on prescribed antiplatelet therapy in the WAKE-UP trial. WAKE-UP was a multicenter, randomized, double-blind, placebo-controlled clinical trial to study the efficacy and safety of MRI-guided intravenous thrombolysis with alteplase in patients with an acute stroke of unknown onset time. The medication history of all patients randomized in the WAKE-UP trial was documented. The primary safety outcome was any sign of hemorrhagic transformation on follow-up MRI. The primary efficacy outcome was favorable functional outcome defined by a score of 0-1 on the modified Rankin scale at 90 days after stroke, adjusted for age and baseline stroke severity. Logistic regression models were fitted to study the association of prior antiplatelet treatment with outcome and treatment effect of intravenous alteplase. Of 503 randomized patients, 164 (32.6%) were on antiplatelet treatment. Patients on antiplatelet treatment were older (70.3 vs. 62.8 years,  <  0.001), and more frequently had a history of hypertension, atrial fibrillation, diabetes, hypercholesterolemia, and previous stroke or transient ischaemic attack. Rates of symptomatic intracranial hemorrhage and hemorrhagic transformation on follow-up imaging did not differ between patients with and without antiplatelet treatment. Patients on prior antiplatelet treatment were less likely to achieve a favorable outcome (37.3% vs. 52.6%,  = 0.014), but there was no interaction of prior antiplatelet treatment with intravenous alteplase concerning favorable outcome ( = 0.355). Intravenous alteplase was associated with higher rates of favorable outcome in patients on prior antiplatelet treatment with an adjusted odds ratio of 2.106 (95% CI 1.047-4.236). Treatment benefit of intravenous alteplase and rates of post-treatment hemorrhagic ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2524-3489 |
| العلاقة: | boreal:241340; http://hdl.handle.net/2078.1/241340Test; info:pmid/33324940; urn:EISSN:2524-3489 |
| DOI: | 10.1186/s42466-020-00087-9 |
| الإتاحة: | https://doi.org/10.1186/s42466-020-00087-9Test http://hdl.handle.net/2078.1/241340Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.642AD0E6 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 25243489 |
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| DOI: | 10.1186/s42466-020-00087-9 |