Abstract 139: Acute Stroke Reperfusion Therapy Trends in the Expanded Treatment Window Era
| Autor: | Ganesh Asaithambi, Xin Tong, Mary G George, Albert W Tsai, James M Peacock, Russell V Luepker, Kamakshi Lakshminarayan |
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| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | Stroke. 45 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/str.45.suppl_1.139 |
| Popis: | BACKGROUND: The American Heart Association/American Stroke Association (AHA/ASA) recommended an expansion of the time window for acute ischemic stroke (AIS) reperfusion with intravenous (IV) recombinant tissue plasminogen activator (rt-PA) from 3 to 4.5 hours after symptom onset. We examined rates of IV and intra-arterial (IA) reperfusion before and after the recommendations to track guideline adoption in community practice. METHODS: Patients with AIS in the Paul Coverdell National Acute Stroke Registry spanning years 2007 to 2012 were identified. Trends in rates of IV rt-PA versus IA therapy were examined. Outcomes studied included symptomatic intracerebral hemorrhage (sICH), in-hospital mortality, ability to ambulate at discharge, and discharge destination. RESULTS: From 2007 to 2012, there were 182,235 AIS patients (median age 72 years, 51.5% women) in the database. AIS patients receiving IV rt-PA increased significantly from 3.7% in 2007 to 5.1% in 2012 in the ≤ 3 hour time window and from 0.2% in 2007 to 1.3% in 2012 in the 3-4.5 hour time window (p CONCLUSION: There was increased utilization of IV rt-PA in the 3-4.5 hour time window from 2007 to 2012, which is likely from guideline recommendations from the AHA/ASA. This increase was associated with an increase in IA treatment rate along with a decrease in overall sICH rates for patients receiving any reperfusion therapy. |
| Databáze: | OpenAIRE |
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