Iodinated Contrast Agents Reduce the Efficacy of Intravenous Recombinant Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients: a Multicenter Cohort Study
Autor: | Mission China Investigators, Haitao Hu, Yi Chen, Chao Xu, Xiaoxian Gong, Zhicai Chen, Min Lou, Zhongyu Luo, Wansi Zhong, Qingqing Li, Xuting Zhang |
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Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment Contrast Media Logistic regression Gastroenterology Brain Ischemia Cohort Studies 03 medical and health sciences 0302 clinical medicine Iodinated contrast Fibrinolytic Agents Informed consent Modified Rankin Scale Internal medicine medicine Humans Thrombolytic Therapy Ischemic Stroke Intracerebral hemorrhage business.industry General Neuroscience Thrombolysis Vascular surgery medicine.disease Clinical trial Stroke 030104 developmental biology Treatment Outcome Tissue Plasminogen Activator Propensity score matching Neurology (clinical) Cardiology and Cardiovascular Medicine business Plasminogen activator 030217 neurology & neurosurgery Cohort study |
Zdroj: | Translational stroke research. 12(4) |
ISSN: | 1868-601X |
Popis: | Background and Purpose: This study aimed to investigate whether the application of iodinated contrast agents before intravenous (IV) recombinant tissue plasminogen activator (rt-PA) reduces the efficacy in acute ischemic stroke (AIS) patients. Methods: We analyzed our prospectively collected data of consecutive AIS patients receiving IV rt-PA treatment in the MISSION study. Clinical outcome at 3 months was assessed with modified Rankin Scale (mRS) score and dichotomized into good outcome (0-2) and poor outcome (3-6). Symptomatic intracerebral hemorrhage (sICH) was defined as cerebral hemorrhagic transformation in combination with clinical deterioration of National Institutes of Health Stroke Scale (NIHSS) score ≥4 points at 24-hour. We performed logistic regression analysis and propensity score matching analysis to investigate the impact of iodinated contrast agents before IV rt-PA on poor outcome and sICH, respectively. Results: A total of 3593 patients were finally included and iodinated contrast agents were used before IV rt-PA among 859 (23.9%) patients. Patients in the iodinated contrast group were more likely to result in poor outcome (39.9% vs 33.4%, P=0.001) and sICH (3.4% vs 1.5%, P |
Databáze: | OpenAIRE |
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