Abstract
Cardiac Thrombus Does Not Increase Post-Alteplase Microbembolic Events: Machine Learning and Propensity Score Augmented Cohort Analysis of 434 Ischemic Stroke Patients with Bayesian Simulated Analysis of 100,000 Patients
Highlights
Stroke kills more patients globally than any other disease outside of ischemic heart disease, with prompt systemic thrombolysis being the standard of care for the majority of strokes [1]
In propensity score adjusted multivariable regression, tissue plasminogen activator (tPA) for cardiac thrombus patients did not significantly increase microembolic events (MEs), length of stay (LOS), nor poor functional outcome
Augmented inverse propensity weighted (AIPW) analysis demonstrated no significant association between tPA and ME
Summary
Stroke kills more patients globally than any other disease outside of ischemic heart disease, with prompt systemic thrombolysis being the standard of care for the majority of strokes (acute ischemic stroke [AIS]) [1]. There is a concern for embolic complications for patients who receive tissue plasminogen activator (tPA) in the setting of cardiac thrombi [2], with an estimated nearly 500,000 stroke patients annually with cardiac thrombus who may be at risk for such post-tPA complications [3,4]. There are no adequately powered (let alone randomized) studies assessing post-thrombolysis embolization in patients with cardiac thrombus and AIS [5]. Our study is the first known to apply state-of-the-art machine learning augmentation of causal inference propensity score analysis (backed by Bayesian statistics to simulate a trial of 100,000 subjects) to evaluate if thrombolysis increases microembolic events (MEs) among cardiac thrombus patients with AIS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
