Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation.

Abstract

The outcome of early intravenous thrombolysis for ischemic stroke in patients with atrial fibrillation (AF) is worse than that without thrombosis. How to increase the efficacy of intravenous thrombolysis for AF-related ischemic stroke remains largely unknown. In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P<0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P=0.045); high systolic pressure (P=0.039); high blood glucose (P=0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P<0.001). Moreover, high systolic pressure at admission (P=0.007), high blood glucose (P=0.027), and a high NIHSS score (P<0.001) were independent risk factors for mortality at 3 months. Besides thrombolysis, a high NIHSS score (P=0.006) and warfarin taken within 48 h before stroke onset (P=0.032) were also independent risk factors for symptomatic hemorrhage within 24 h after treatment. Ischemic stroke patients with AF benefited from intravenous thrombolysis with recombinant tissue plasminogen activator within 4.5 h after stroke.