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Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator

BACKGROUND: Symptomatic Intracerebral hemorrhage (sICH) is a serious complication of recombinant tissue-plasminogen activator (rt-PA) therapy for acute ischemic stroke (AIS). OBJECTIVE: To estimate the prevalence and predictors of sICH in patients after receiving IV rt-PA for AIS. MATERIAL AND METHO...

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Autores principales: Chenna, Vijay, Kaul, Subhash, Tandra, Swetha, Yareeda, Sireesha, Mathukumalli, Neeharika, Kohat, Abhijeet Kumar, Kandadai, Rukmini Mridula, Turaga, Suryaprabha, Sheik, Jabeen Afshan, Meena, A. K., Borgohain, Rupam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137634/
https://www.ncbi.nlm.nih.gov/pubmed/30258265
http://dx.doi.org/10.4103/aian.AIAN_228_17
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author Chenna, Vijay
Kaul, Subhash
Tandra, Swetha
Yareeda, Sireesha
Mathukumalli, Neeharika
Kohat, Abhijeet Kumar
Kandadai, Rukmini Mridula
Turaga, Suryaprabha
Sheik, Jabeen Afshan
Meena, A. K.
Borgohain, Rupam
author_facet Chenna, Vijay
Kaul, Subhash
Tandra, Swetha
Yareeda, Sireesha
Mathukumalli, Neeharika
Kohat, Abhijeet Kumar
Kandadai, Rukmini Mridula
Turaga, Suryaprabha
Sheik, Jabeen Afshan
Meena, A. K.
Borgohain, Rupam
author_sort Chenna, Vijay
collection PubMed
description BACKGROUND: Symptomatic Intracerebral hemorrhage (sICH) is a serious complication of recombinant tissue-plasminogen activator (rt-PA) therapy for acute ischemic stroke (AIS). OBJECTIVE: To estimate the prevalence and predictors of sICH in patients after receiving IV rt-PA for AIS. MATERIAL AND METHODS: Consecutive patients of AIS thrombolysed between January 2010 and June 2016 in a University hospital in Hyderabad (India) were studied prospectively for sICH and it's various variables compared with the control group without sICH to determine any sigificantant difference. RESULTS: Out of 113 patients , sICH was detected in 12 (10.61%) whose mean age(58±12.0 years) and gender ratio ( 2:1 ) was not statistically significant from controls. In s ICH group mean NIHSS score was 16.53± 5.81 vs 10.19± 5.06 in controls (p<0.001), gap between stroke onset and thrombolysis was 227.50±46.15 min vs 178.50± 69.20 min in controls(p=0.018). At presentation mean blood sugar was 208.75±90.97 mg/dl in sICH group vs 146.83±70.21 mg/dl in controls (p=0.002). Prior diabetes was in 7(53.30%) vs 23 (22.8%) in controls (p= 0.014)and hypertension in 11 (91.7%) vs (56(55.4%) in controls (p= 0.026) The mortality in sICH was 7 (58.30%)vs 4 (4.94%) in controls (p<.0.001). At 3 months mean mRS ofsICH patients was 5.57± 0.54 vs 2.17± 1.69 in controls (p<.05). CONCLUSION: High NIHSS score, increased stroke onset to thrombolysis time , high blood sugar at presentation ,prior diabetes and hypertension increase the chances of sICH. None of these contraindicate thrombolysing strokes but should caution the physician.
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spelling pubmed-61376342018-09-26 Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator Chenna, Vijay Kaul, Subhash Tandra, Swetha Yareeda, Sireesha Mathukumalli, Neeharika Kohat, Abhijeet Kumar Kandadai, Rukmini Mridula Turaga, Suryaprabha Sheik, Jabeen Afshan Meena, A. K. Borgohain, Rupam Ann Indian Acad Neurol Original Article BACKGROUND: Symptomatic Intracerebral hemorrhage (sICH) is a serious complication of recombinant tissue-plasminogen activator (rt-PA) therapy for acute ischemic stroke (AIS). OBJECTIVE: To estimate the prevalence and predictors of sICH in patients after receiving IV rt-PA for AIS. MATERIAL AND METHODS: Consecutive patients of AIS thrombolysed between January 2010 and June 2016 in a University hospital in Hyderabad (India) were studied prospectively for sICH and it's various variables compared with the control group without sICH to determine any sigificantant difference. RESULTS: Out of 113 patients , sICH was detected in 12 (10.61%) whose mean age(58±12.0 years) and gender ratio ( 2:1 ) was not statistically significant from controls. In s ICH group mean NIHSS score was 16.53± 5.81 vs 10.19± 5.06 in controls (p<0.001), gap between stroke onset and thrombolysis was 227.50±46.15 min vs 178.50± 69.20 min in controls(p=0.018). At presentation mean blood sugar was 208.75±90.97 mg/dl in sICH group vs 146.83±70.21 mg/dl in controls (p=0.002). Prior diabetes was in 7(53.30%) vs 23 (22.8%) in controls (p= 0.014)and hypertension in 11 (91.7%) vs (56(55.4%) in controls (p= 0.026) The mortality in sICH was 7 (58.30%)vs 4 (4.94%) in controls (p<.0.001). At 3 months mean mRS ofsICH patients was 5.57± 0.54 vs 2.17± 1.69 in controls (p<.05). CONCLUSION: High NIHSS score, increased stroke onset to thrombolysis time , high blood sugar at presentation ,prior diabetes and hypertension increase the chances of sICH. None of these contraindicate thrombolysing strokes but should caution the physician. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6137634/ /pubmed/30258265 http://dx.doi.org/10.4103/aian.AIAN_228_17 Text en Copyright: © 2018 Annals of Indian Academy of Neurology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Chenna, Vijay
Kaul, Subhash
Tandra, Swetha
Yareeda, Sireesha
Mathukumalli, Neeharika
Kohat, Abhijeet Kumar
Kandadai, Rukmini Mridula
Turaga, Suryaprabha
Sheik, Jabeen Afshan
Meena, A. K.
Borgohain, Rupam
Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator
title Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator
title_full Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator
title_fullStr Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator
title_full_unstemmed Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator
title_short Predictors of Intracerebral Hemorrhage in Acute Stroke Patients Receiving Intravenous Recombinant Tissue Plasminogen Activator
title_sort predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137634/
https://www.ncbi.nlm.nih.gov/pubmed/30258265
http://dx.doi.org/10.4103/aian.AIAN_228_17
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