0000000000261137
AUTHOR
Nicolas Martinez-majander
Association of prestroke metformin use, stroke severity, and thrombolysis outcome
ObjectiveTo evaluate whether pretreatment with metformin (MET) is associated with less stroke severity and better outcome after IV thrombolysis (IVT), we analyzed a cohort of 1,919 patients with stroke with type 2 diabetes mellitus in a multicenter exploratory analysis.MethodsData from patients with diabetes and ischemic stroke treated with IVT were collected within the European Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration. We applied propensity score matching (PSM) to obtain balanced baseline characteristics of patients treated with and without MET.ResultsOf 1,919 patients with stroke with type 2 diabetes who underwent IVT, 757 (39%) had received MET before stroke (MET+),…
Intravenous thrombolysis for suspected ischemic stroke with seizure at onset
Objective Seizure at onset (SaO) has been considered a relative contraindication for intravenous thrombolysis (IVT) in patients with acute ischemic stroke, although this appraisal is not evidence based. Here, we investigated the prognostic significance of SaO in patients treated with IVT for suspected ischemic stroke. Methods In this multicenter, IVT-registry-based study we assessed the association between SaO and symptomatic intracranial hemorrhage (sICH, European Cooperative Acute Stroke Study II definition), 3-month mortality, and 3-month functional outcome on the modified Rankin Scale (mRS) using unadjusted and adjusted logistic regression, coarsened exact matching, and inverse probabil…
Non-office-hours admission affects intravenous thrombolysis treatment times and clinical outcome
In patients treated with intravenous thrombolysis (IVT), an unfavourable ‘non-office-hours effect’ on door-to-needle time (DNT) and clinical outcome has been suggested. This effect has been attributed to a number of factors, mostly related to either less efficient logistics or less (experienced) staffing during non-office hours (NH). These factors could result in longer DNTs and more protocol violations and thus in worse clinical outcome. On the other hand, one could also argue that the workload during NH is lower, which could result in less time delays in the various diagnostic processes and thus in better clinical outcome. Our hypothesis is that admission during NH has a negative effect o…
Intracerebral Hemorrhage and Outcome After Thrombolysis in Stroke Patients Using Selective Serotonin-Reuptake Inhibitors.
Background and Purpose— Selective serotonin-reuptake inhibitors (SSRIs) impair platelet function and have been linked to a higher risk of spontaneous intracerebral hemorrhage—an association that may be augmented by oral anticoagulants (OAC). We aimed to assess whether preadmission treatment with SSRIs in patients with acute ischemic stroke is associated with post-thrombolysis symptomatic intracerebral hemorrhage (sICH) and functional outcome. Methods— A multicenter retrospective analysis was conducted in prospective registries of patients treated by thrombolysis within 4.5 hours of stroke onset. The association between preadmission treatment with SSRIs and sICH (ECASS II definition [Europe…