Influence of antiplatelet therapy before rt-PA thrombolytic on thrombolytic effects and prognosis in patients with cerebral infarction

Abstract

Objective To investigate the effects of antiplatelet therapy before intravenous thrombolysis of recombinant tissue plasminogen activator (rt-PA) on thrombolytic effects and prognosis in patients with cerebral infarction. Methods The clinical data of 96 patients with cerebral infarction admitted to Department of Neurology of Yuncheng Central Hospital from May 2014 to December 2018 were retrospectively analyzed. All the patients were divided into two groups according to whether antiplatelet therapy was used before rt-PA thrombolysis for them. Forty-eight cases in the control group received thrombolytic therapy only, and 48 cases in the study group received antiplatelet therapy before rt-PA thrombolytic therapy. The thrombolytic effects, prognosis and safety of the two groups were observed. Results After rt-PA thrombolysis treatment, the good rates of thrombolysis 24 hours and 7 days after thrombolysis in the study group (66.67% and 70.83%) were higher than those in the control group (45.83% and 50.00%), and the difference was statistically significant (P 0.05). Within 90 days after thrombolytic therapy, there was no significant difference in the incidence of asymptomatic intracranial hemorrhage (8.33% vs. 4.17%), the incidence of symptomatic intracranial hemorrhage (6.25% vs. 4.17%) and the mortality rate (4.17% vs. 2.08%) between the control group and the study group (P>0.05). Conclusions Antiplatelet therapy before rt-PA thrombolysis can improve the recent thrombolytic effects in patients with cerebral infarction. And it has no significant effect on the long-term prognosis, without increase in the risk of intracranial hemorrhage and the risk of mortality, so it has safety. Key words: Recombinant tissue plasminogen activator; Thrombolysis; Antiplatelet therapy; Cerebral infarction