Fibrinogen Concentrate for the Treatment of Thrombolysis-Associated Hemorrhage in Adult Ischemic Stroke Patients
| Autor: | Steven K. Feske, Charlene Ong, Galen V. Henderson, Eva Rybak, Patricia Krause, Megan E Barra, Sarah E Culbreth, Katelyn W. Sylvester |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
thrombolysis medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_treatment 030204 cardiovascular system & hematology Fibrinogen Gastroenterology Brain Ischemia Therapeutic Approaches for the Treatment of Cerebral-Neurovascular Diseases 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Stroke Aged Ischemic Stroke Retrospective Studies Aged 80 and over Intracerebral hemorrhage Cerebral infarction business.industry Hematology General Medicine Thrombolysis Middle Aged Hypofibrinogenemia cerebral infarction medicine.disease intracerebral hemorrhage stroke lcsh:RC666-701 Cryoprecipitate Hemostasis hemostasis Original Article Female business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Clinical and Applied Thrombosis/Hemostasis, Vol 26 (2020) Clinical and Applied Thrombosis/Hemostasis |
| ISSN: | 1938-2723 |
| Popis: | In patients with ischemic stroke who receive systemic recombinant tissue plasminogen activator (rt-PA), the risk of secondary hemorrhage is 1-7%. Fibrinogen supplementation with cryoprecipitate is recommended in patients with rt-PA-associated symptomatic hemorrhage. We examined whether fibrinogen concentrate can be used safely in this setting. A single-center retrospective case series was performed in patients who received fibrinogen concentrate for post-rt-PA hemorrhage between January-2012 and December-2017. The primary outcome was the incidence of in-hospital thromboembolic events and infusion reactions. Secondary outcomes included incidence of clinically significant ICH expansion within 24-hours and patient serum fibrinogen response to fibrinogen concentrate therapy. Thromboembolic events occurred in 3 (12.5%) of 24 patients included in the analysis. No patients experienced infusion-related reactions. Five of 22 patients with ICH experienced clinically significant hemorrhage expansion. Hypofibrinogenemia was corrected in 87.5%(7/8) of patients with baseline hypofibrinogenemia, with a median increase in serum fibrinogen 166 mg/dL. Median fibrinogen increase in patients without baseline hypofibrinogenemia was 18 mg/dL. Fibrinogen concentrate is a safe potential therapeutic option to restore fibrinogen levels in acute ischemic stroke patients with thrombolysis-associated hemorrhage. |
| Databáze: | OpenAIRE |
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