Postthrombolytic Antiplatelet Use for Patients with Intercerebral Hemorrhage without Extensive Parenchymal Involvement Does Not Worsen Outcome
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Background and Purpose It is unclear whether postthrombolytic antiplatelet (AP) therapy after thrombolytic-related hemorrhage without extensive parenchymal involvement (THEPI) afects the clinical outcome. Tis study explored whether AP administration in patients with THEPI afects short- and long-term outcomes. Methods All of the data for this study were collected from the Trombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) registry. Patients with THEPI were assigned to either the AP (AP therapy should be commenced 24 h afer intravenous thrombolysis) or AP-naïve groups. THEPI was defned according to European-Australasian Acute Stroke Study II criteria. Te 90-day functional outcome, 7-day National Institutes of Health Stroke Scale (NIHSS) score, and 7-day and 90-day mortalities were compared between the AP and AP-naïve groups. Logistic regression analysis was used to evaluate the effects of AP therapy on the short- and long-term clinical outcomes. Results Of the 928 patients enrolled from those in the TIMS-China registry (n=1,440), 89 (9.6%) had nonsymptomatic intracerebral hemorrhage (ICH) within 24–36 h afer thrombolysis; 33 (37%) of these patients were given AP therapy (AP group) and 56 (63%) were not (APnaïve group). No significant differences were found for the risk of 7-day aggravated ICH (p=0.998), 7-day NIHSS score (p=0.5491), 7-day mortality [odds ratio (OR)=3.427; 95% confdence interval (95% CI)=0.344–34.160; p=0.294], 90-day mortality (OR=0.788, 95% CI=0.154– 4.040, p=0.775), or modifed Rankin score 5 or 6 at 90-days (OR=1.108, 95% CI=0.249–4.928, p=0.893) between the AP and AP-naïve groups afer THEPI. Conclusions Early administration of postthrombolytic AP therapy afer THEPI does not worsen either the short- or long-term outcome. AP therapy may be a reasonable treatment option for patients with THEPI to reduce the risk of ischemic stroke recurrence.
Abstract
Background and Purpose It is unclear whether postthrombolytic antiplatelet (AP) therapy after thrombolytic-related hemorrhage without extensive parenchymal involvement (THEPI) afects the clinical outcome. Tis study explored whether AP administration in patients with THEPI afects short- and long-term outcomes. Methods All of the data for this study were collected from the Trombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) registry. Patients with THEPI were assigned to either the AP (AP therapy should be commenced 24 h afer intravenous thrombolysis) or AP-naïve groups. THEPI was defned according to European-Australasian Acute Stroke Study II criteria. Te 90-day functional outcome, 7-day National Institutes of Health Stroke Scale (NIHSS) score, and 7-day and 90-day mortalities were compared between the AP and AP-naïve groups. Logistic regression analysis was used to evaluate the effects of AP therapy on the short- and long-term clinical outcomes. Results Of the 928 patients enrolled from those in the TIMS-China registry (n=1,440), 89 (9.6%) had nonsymptomatic intracerebral hemorrhage (ICH) within 24–36 h afer thrombolysis; 33 (37%) of these patients were given AP therapy (AP group) and 56 (63%) were not (APnaïve group). No significant differences were found for the risk of 7-day aggravated ICH (p=0.998), 7-day NIHSS score (p=0.5491), 7-day mortality [odds ratio (OR)=3.427; 95% confdence interval (95% CI)=0.344–34.160; p=0.294], 90-day mortality (OR=0.788, 95% CI=0.154– 4.040, p=0.775), or modifed Rankin score 5 or 6 at 90-days (OR=1.108, 95% CI=0.249–4.928, p=0.893) between the AP and AP-naïve groups afer THEPI. Conclusions Early administration of postthrombolytic AP therapy afer THEPI does not worsen either the short- or long-term outcome. AP therapy may be a reasonable treatment option for patients with THEPI to reduce the risk of ischemic stroke recurrence.
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