[Intravenous thrombolytic therapy of ischemic stroke with the drug Revelisa in real clinical practice: results of the IVT-AIS-R study].

Autor:	Soldatov MA; Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology, Moscow, Russia.; Scientific Research Institute of Healthcare Organization and Medical Management, Moscow, Russia., Klimov LV; Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology, Moscow, Russia., Tolmachev AP; Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology, Moscow, Russia., Kiseleva TV; Scientific Research Institute of Healthcare Organization and Medical Management, Moscow, Russia., Androfagina OV; Seredavin Samara Regional Clinical Hospital, Samara, Russia., Beketova EM; Pirogov Samara City Clinical Hospital, Samara, Russia., Belkina SN; Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.; Voskresenskaya First District Hospital, Voskresensk, Russia., Borisov DN; Kirov Regional Clinical Hospital, Kirov, Russia., Karpov DY; City Hospital No. 5, Barnaul, Russia., Krasyuk MS; Bryansk City Hospital No. 1, Bryansk, Russia., Kucheryavaya MV; Sergiev Posad District Hospital, Sergiev Posad, Russia., Minina YD; Seredavin Samara Regional Clinical Hospital, Samara, Russia., Novikov DG; Sergiev Posad District Hospital, Sergiev Posad, Russia., Rogozhnikova NV; Novokuetsky Branch of the Barbarash Kemerovo Regional Clinical Cardiology Dispensary, Novokuznetsk, Russia.; Novokuetsk State Institute of Advanced Medical Training - Branch of the Russian Medical Academy of Continuing Medical Education, Novokuznetsk, Russia., Tabakman SV; Pirogov City Hospital No. 1, Sevastopol, Russia., Teliatnik YA; Ochapovsky Research Institute - Regional Clinical Hospital No. 1, Krasnodar, Russia., Tretyakov KV; Berzon Krasnoyarsk Interdistrict Clinical Hospital No. 20, Krasnoyarsk, Russia., Fadeeva AS; Vladivostok Clinical Hospital No. 1, Vladivostok, Russia., Khan DS; Primorsky Regional Clinical Hospital No. 1, Vladivostok, Russia., Chirkov AN; Orenburg Regional Clinical Hospital, Orenburg, Russia., Marskaya NA; Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology, Moscow, Russia., Shamalov NA; Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova [Zh Nevrol Psikhiatr Im S S Korsakova] 2022; Vol. 122 (12. Vyp. 2), pp. 42-49.
DOI:	10.17116/jnevro202212212242
Abstrakt:	Objective: Evaluation of the safety and effectiveness of thrombolytic therapy (TLT) with the drug Revelisa (alteplase) in patients with ischemic stroke (AI) in real clinical practice. Material and Methods: An open prospective multicenter non-interventional register study was conducted, which included 550 patients with AI - 259 (47.1%) women and 291 (52.9%) men; average age 67.7±12.6 years. All included patients underwent TLT with the drug Revelisa within 4.5 hours from the onset of the disease and, according to the protocol of reperfusion therapy of AI, clinical, instrumental and laboratory examinations were performed. Symptomatic hemorrhagic transformation (GT) was determined in accordance with the criteria of the ECASS 3 study. Results: The majority of patients (95.8%) suffered from hypertension, 69.6% had chronic heart failure, 53.8% had coronary heart disease, 38.7% had various cardiac arrhythmias, 20.7% of patients suffered from type 2 diabetes mellitus. A day after TLT, an improvement of 4 points or more on the NIHSS scale was noted in 45% of patients. The average dynamics index on the NIHSS stroke scale after a day was -3.2±4.7 and -4.4±6.1 per 7 females ( p <0.0001). GT of the lesion of the brain developed in 10.9% of cases, symptomatic GT was diagnosed in 12 (2.3%) patients. The hospital mortality rate was 12.7%. The proportion of patients with good functional recovery (0-2 points on the modified Rankin scale (mRS)) at discharge, on days 30 and 90 was 44.7%, 59.2% and 68.5%, respectively. Conclusion: Performing TLT with the drug Revelisa in patients with AI leads to a statistically significant regression of neurological symptoms. A significant proportion of patients achieve a favorable clinical outcome upon discharge from the hospital and in the long term. The obtained data on the efficacy and safety profile correlate with previously published register studies of alteplase in AI.
Databáze:	MEDLINE
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