Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation

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• 作者：Qiuyun Zhao ; Xiaobo Li ; Wanli Dong ; Min Ye ; Yongjun Cao…
• 关键词：Ischemic stroke ; Atrial fibrillation ; Intravenous recombinant tissue plasminogen activator ; Intravenous thrombolysis ; Favorable outcome ; Risk factors
• 刊名：Neuroscience Bulletin
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：32
• 期：2
• 页码：145-152
• 全文大小：556 KB
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• 作者单位：Qiuyun Zhao (1) (2) (3) (4)
  Xiaobo Li (3) (5)
  Wanli Dong (3) (6)
  Min Ye (3) (7)
  Yongjun Cao (3) (8)
  Meijuan Zhang (1) (3) (4)
  Qiantao Cheng (3) (9)
  Junshan Zhou (10) (3)
  Guofang Chen (11) (3)
  Ming Yu (12) (3)
  Shanshan Hong (13) (3)
  Xiue Wei (14) (3)
  Bei Wang (15) (3)
  Guiyun Cui (16) (3)
  Peng Zhang (17) (3)
  Hong Ding (17) (3)
  Rongzhen Xu (18) (3)
  Yan Chen (19) (3) (4)
  Yun Xu (1) (20) (3) (4)
  
  1. Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China
  2. Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
  3. Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China
  4. Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, 210008, China
  5. Department of Neurology, Northern Jiangsu People’s Hospital, Yangzhou, 225001, China
  6. Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
  7. Department of Neurology, Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, 210019, China
  8. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
  9. Department of Neurology, The Affiliated Huaian First People’s Hospital of Nanjing Medical University, Huaian, 223300, China
  10. Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
  11. Department of Neurology, Affiliated Xuzhou Central Hospital of Xuzhou Medical College, Xuzhou, 221009, China
  12. Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, 212002, China
  13. Department of Neurology, Jiangyin People’s Hospital, Jiangyin, 214400, China
  14. Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221006, China
  15. Department of Neurology, The First People’s Hospital of Lianyungang, Lianyungang, 222002, China
  16. Department of Neurology, The First Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221000, China
  17. Department of Neurology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China
  18. Department of Neurology, Gaochun People’s Hospital, Nanjing, 211300, China
  19. Department of Neurology, Drum Tower Hospital of Nanjing Medical University, Nanjing, 210008, China
  20. Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, 210008, China
  
• 刊物主题：Neurosciences; Human Physiology; Anesthesiology; Anatomy; Neurology; Pain Medicine;
• 出版者：Springer Berlin Heidelberg
• ISSN：1995-8218

文摘

The outcome of early intravenous thrombolysis for ischemic stroke in patients with atrial fibrillation (AF) is worse than that without thrombosis. How to increase the efficacy of intravenous thrombolysis for AF-related ischemic stroke remains largely unknown. In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P < 0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P = 0.045); high systolic pressure (P = 0.039); high blood glucose (P = 0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001). Moreover, high systolic pressure at admission (P = 0.007), high blood glucose (P = 0.027), and a high NIHSS score (P < 0.001) were independent risk factors for mortality at 3 months. Besides thrombolysis, a high NIHSS score (P = 0.006) and warfarin taken within 48 h before stroke onset (P = 0.032) were also independent risk factors for symptomatic hemorrhage within 24 h after treatment. Ischemic stroke patients with AF benefited from intravenous thrombolysis with recombinant tissue plasminogen activator within 4.5 h after stroke.