SAFETY AND OUTCOME OF INTRAVENOUS THROMBOLYSIS WITH rtPA IN PATIENTS WITH ATRIAL FIBRILLATION

• Main Authors: Elena Terecoasa, Cristina Tiu, Marta Guillan, Victor Sanchez-Gonzalez, Maria Alonso de Lecinana, Jaime Masjuan
• Format: Article
• Language: English
• Published: Amaltea Medical Publishing House 2012-09-01
• Series: Romanian Journal of Neurology
• Subjects: thrombolysis; rtpa; atrial fi brillation; cardioembolic stroke; outcome; safety
• Online Access: https://revistemedicale.amaltea.ro/Romanian_Journal_of_NEUROLOGY/Revista_Romana_de_NEUROLOGIE-2012-Nr.3/RJN_2012_3_Art-03.pdf
• ISSN: 1843-8148; 2069-6094

Background and purpose. Intravenous administration of recombinant tissue plasminogen activator (rtPA) is approved for the treatment of patients with acute ischemic stroke. It is still controversial if in patients with ischemic stroke due to atrial fibrillation this treatment has the same efficacy as in patients with ischemic stroke due to other etiologies. The present study aimed to compare the safety and outcome of intravenous thrombolysis with rtPA between patients with stroke due to atrial fibrillation, due to other cardiac sources of emboli and due to large-vessel disease. Methods. Retrospective analysis of 463 patients treated with rtPA in the Stroke Unit of Ramon y Cajal University Hospital, Madrid, between January 2004 and December 2011. Patients were divided in three subgroups according to stroke etiology: cardioembolic stroke due to atrial fibrillation, cardioembolic stroke due to a cardiac disease other than atrial fibrillation, stroke due to large-vessel disease. The outcome measures of the study were: symptomatic intracranial hemorrhage transformation, modified Rankin score and mortality at three months. Results. The results of the multivariate analysis showed that stroke etiology has no influence on functional outcome (p = 0.181), symptomatic intracranial hemorrhage (p = 0.093) and mortality at three months (p = 0.091). Age and baseline NIHSS scores are independent predictors for both functional outcome and mortality. Conclusion. Stroke outcome after intravenous thrombolysis with rtPA is not influenced by the stroke etiology.