Abstract
Ischemic stroke is the most common type of stroke. Intravenous thrombolytic therapy with alteplase is currently the most effective method to improve the prognosis of patients with acute cerebral infarction. The purpose of this study was to investigate the efficacy and safety of intravenous thrombolysis with alteplase in patients with acute ischemic stroke combined with atrial fibrillation and to analyze the related influencing factors. It turns out, alteplase intravenous thrombolysis is effective for patients with ICS combined with atrial fibrillation, and the incidence of sICH are lower than those without alteplase intravenous thrombolysis, but the efficacy is worse than that of patients without atrial fibrillation. At the same time, the baseline NHISS score and systolic pressure before the thrombolytic were independent risk factors affecting the efficacy of intravenous thrombolysis with alteplase in ICS patients with atrial fibrillation. This study has provided a scientific basis for making an active decision to perform ultraearly intravenous thrombolysis in our hospital to reduce the mortality and disability rate of stroke in the region.
Highlights
Acute ischemic stroke (CIS) is the infarction of brain tissue caused by the occlusion of a cerebral artery, accompanied by the damage of neurons, astrocytes, and oligodendrocytes, which has the characteristics of high morbidity, high mortality, and a high disability rate [1, 2]
Inclusion Criteria. e inclusion criteria were as follows: all patients who were confirmed to have ICS by head CT and/ or MRI [7]; patients with neurologic impairment symptoms caused by ischemic stroke; patients whose intracranial hemorrhage has been excluded by cerebral CT without imaging changes of early massive cerebral infarction [8]; patients aged > 18 years; patients whose onset time reaches the admission time ≤ 4.5 h; and the patient or family members who have signed the informed consent form for intravenous thrombolysis. is study was approved by the ethics committee, and the informed consent form was signed by the patient or his/her family
Despite the efficacy of conventional antiplatelet or anticoagulant therapy in ICS, evidence-based medicine indicates that intravenous thrombolytic therapy with retissue-type plasminogen activator remains the dominant approach for ultraearly treatment of ICS [13]
Summary
Acute ischemic stroke (CIS) is the infarction of brain tissue caused by the occlusion of a cerebral artery, accompanied by the damage of neurons, astrocytes, and oligodendrocytes, which has the characteristics of high morbidity, high mortality, and a high disability rate [1, 2]. Atrial fibrillation is a common arrhythmia and an independent risk factor for CIS. E occurrence of atrial fibrillation increases the severity of CIS and increases the incidence of other complications and poor prognosis [5]. Is study analyzed the efficacy, influencing factors, and safety of intravenous thrombolysis with alteplase in patients with CIS complicated with atrial fibrillation, aiming to provide theoretical support for making a positive decision of ultraearly intravenous thrombolysis and reduce the mortality and disability rate of stroke in this region, which was reported as follows The efficacy and safety of intravenous thrombolysis for CIS patients with atrial fibrillation are controversial, as is whether atrial fibrillation affects the efficacy of intravenous thrombolysis for CIS patients [6]. is study analyzed the efficacy, influencing factors, and safety of intravenous thrombolysis with alteplase in patients with CIS complicated with atrial fibrillation, aiming to provide theoretical support for making a positive decision of ultraearly intravenous thrombolysis and reduce the mortality and disability rate of stroke in this region, which was reported as follows.
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