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Cited 4 time in webofscience Cited 5 time in scopus
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Prestroke Antiplatelet Effect on Symptomatic Intracranial Hemorrhage and Functional Outcome in Intravenous Thrombolysis

Authors
Choi, Jay CholLee, Ji SungPark, Tai HwanCho, Yong-JinPark, Jong-MooKang, KyusikLee, Kyung BokLee, Soo JooKim, Jae GukLee, JunPark, Man-SeokChoi, Kang-HoKim, Joon-TaeYu, Kyung-HoLee, Byung-ChulOh, Mi-SunCha, Jae-KwanKim, Dae-HyunNah, Hyun-WookKim, Dong-EogRyu, Wi-SunKim, Beom JoonBae, Hee-JoonKim, Wook-JooShin, Dong-IckYeo, Min-JuIl Sohn, SungHong, Jeong-HoLee, JuneyoungHong, Keun-Sik
Issue Date
Sep-2016
Publisher
KOREAN STROKE SOC
Keywords
Stroke; Thrombolytic therapy; Platelet aggregation inhibitors; Outcome assessment
Citation
JOURNAL OF STROKE, v.18, no.3, pp.344 - 351
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF STROKE
Volume
18
Number
3
Start Page
344
End Page
351
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/6117
DOI
10.5853/jos.2016.00185
ISSN
2287-6391
Abstract
Background and Purpose About 30%-40% of stroke patients are taking antiplatelet at the time of their strokes, which might increase the risk of symptomatic intracranial hemorrhage (SICH) with intravenous tissue plasminogen activator (IV-TPA) therapy. We aimed to assess the effect of pre stroke antiplatelet on the SICH risk and functional outcome in Koreans treated with IV-TPA. Methods From a prospective stroke registry, we identified patients treated with IV-TPA between October 2009 and November 2014. Prestroke antiplatelet use was defined as taking antiplatelet within 7 days before the stroke onset. The primary outcome was SIGH. Secondary outcomes were discharge modified Rankin Scale (mRS) score and in-hospital mortality. Results Of 1,715 patients treated with IV-TPA, 441 (25.7%) were on prestroke antiplatelet. Pre-stroke antiplatelet users versus non-users were more likely to be older, to have multiple vascular risk factors. Prestroke antiplatelet use was associated with an increased risk of SICH (5.9% vs. 3.0%; adjusted odds ratio [OR] 1.79 [1.05-3.04]). However, at discharge, the two groups did not differ in mRS distribution (adjusted OR 0.90 [0.72-1.14]), mRS 0-1 outcome (34.2% vs. 33.7%; adjusted OR 1.27 [0.94-1.72), mRS 0-2 outcome (52.4% vs. 52.9%; adjusted OR 1.21 [0.90-1.63]), and in-hospital mortality (6.1% vs. 4.2%; adjusted OR 1.19 [0.71-2.01]). Conclusions Despite an increased risk of SICH, prestroke antiplatelet users compared to non-users had comparable functional outcomes and in-hospital mortality with IV-TPA therapy. Our results support the use of IV-TPA in eligible patients taking antiplatelet therapy before their stroke onset.
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