Cerebral thrombolysis in patients with ischemic stroke and heart failure.

Autor:	Sobolewski P; The Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland; Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Poland. Electronic address: piotrsobolewski@poczta.onet.pl., Kozera G; Department of Neurology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland., Szczuchniak W; Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Poland., Sobota A; Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Poland., Chwojnicki K; Department of Neurology, Medical University of Gdańsk, Poland., Gruchała M; First Department of Cardiology, Medical University of Gdańsk, Poland., Nyka WM; Department of Neurology, Medical University of Gdańsk, Poland.
Jazyk:	angličtina
Zdroj:	Neurologia i neurochirurgia polska [Neurol Neurochir Pol] 2018 Sep - Oct; Vol. 52 (5), pp. 593-598. Date of Electronic Publication: 2018 Aug 17.
DOI:	10.1016/j.pjnns.2018.08.003
Abstrakt:	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. (Copyright © 2018 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved.)
Databáze:	MEDLINE
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