Safety and efficacy of remote ischemic postconditioning after thrombolysis in patients with stroke
| Autor: | Aifeng Zhang, Min-jie Gong, Xingyun Yuan, Wen-feng Song, Guoliang Li, Yichen Guo, Meng Wei, Guogang Luo, Yonglan Tang, Yawen Cheng, Jiaqi An, Chun-ying Mu, Ardan M. Saguner |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Vascular Endothelial Growth Factor A medicine.medical_treatment S100 Calcium Binding Protein beta Subunit 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Fibrinolytic Agents Modified Rankin Scale law Outcome Assessment Health Care Clinical endpoint Medicine Humans Ischemic Postconditioning Stroke Aged Ischemic Stroke business.industry Thrombolysis Odds ratio Length of Stay Middle Aged medicine.disease Combined Modality Therapy Confidence interval Tolerability Anesthesia Tissue Plasminogen Activator Administration Intravenous Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Neurology. 95(24) |
| ISSN: | 1526-632X |
| Popis: | ObjectiveTo determine the effect of remote ischemic postconditioning (RIPC) on patients with acute ischemic stroke (AIS) undergoing IV thrombolysis (IVT).MethodsA single-center randomized controlled trial was performed with patients with AIS receiving IVT. Patients in the RIPC group were administered RIPC treatment (after IVT) during hospitalization. The primary endpoint was a score of 0 or 1 on the modified Rankin scale (mRS) at day 90. The safety, tolerability, and neuroprotection biomarkers associated with RIPC were also evaluated.ResultsWe collected data from both the RIPC group (n = 34) and the control group (n = 34). The average duration of hospitalization was 11.2 days. There was no significant difference between 2 groups at admission for the NIH Stroke Scale score (p = 0.364) or occur-to-treatment time (p = 0.889). Favorable recovery (mRS score 0–1) at 3 months was obtained in 71.9% of patients in the RIPC group vs 50.0% in the control group (adjusted odds ratio 9.85, 95% confidence interval 1.54–63.16; p = 0.016). We further found significantly lower plasma S100-β (p = 0.007) and higher vascular endothelial growth factor (p = 0.003) levels in the RIPC group than in the control group.ConclusionsRepeated RIPC combined with IVT can significantly facilitate recovery of nerve function and improve clinical prognosis of patients with AIS.ClinicalTrials.gov identifierNCT03218293.Classification of evidenceThis study provides Class IV evidence that RIPC after tissue plasminogen activator treatment of AIS significantly increases the proportion of patients with an MRS score of 0 or 1 at 90 days. |
| Databáze: | OpenAIRE |
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