Abstract TP25: Early Major Neurologic Improvement after Endovascular Therapy in Acute Ischemic Stroke

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Luzma Cardona ◽  
Dolora Wisco ◽  
Shu-Mei Man ◽  
Pravin George ◽  
Esteban Cheng-Ching ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
Favorable Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Neurological Improvement ◽  
Arterial Recanalization ◽  
Pre Treatment

Background and Purpose: Intravenous thrombolysis is associated with early major neurologic improvement, which is reported to occur in about a quarter of patients after 24 hrs. The aim of the study is to evaluate the frequency and predictors of early major improvement in patient with ischemic stroke after undergoing acute intra-arterial therapy. Materials and methods: Prospective collected database of patients undergoing intra-arterial therapy for the acute ischemic stroke from January 2008 to December 2011 was reviewed. The NIHSS was used to assess severity of stroke in patients upon admission, 24 hrs after procedure and at hospital discharge. Major neurological improvement was defined as improvement of NIHSS by more or equal to 8 or absolute NIHSS of 0 or 1. Arterial recanalization was defined as thrombolysis in cerebral infarction grade 2b or 3. Favorable outcome was defined as modified Rankin scale of 0-2 at 1 month and 3 months. Demographic and radiographic data were collected. Results: MNI was seen in 28 out of 138 (20%) of patients at 24 hours but was not associated with a 30 day or 90 day favorable outcome. MNI at discharge was seen in 47 of 148 (31%) patients and was associated with a 30 day and 90 day favorable outcomes of 0-2 on mRankin (Odds Ratio (OR) : 9.1, 95% confidence interval (CI): 3.7-22.5). Recanalization was associated with MNI at 24 hours (OR 3.1, 95% CI: 1.2-7.9) and MNI at discharge (OR 2.8, 95% CI: 1.3-6.0). Among pre-treatment variables, MNI at discharge was associated with imaging by pre-treatment Alberta Stroke Program Early CT Score (median 9 with MNI, 8 without MNI, p=0.03) and time to treatment (median 5.2 hours with MNI v 7.2 hours without MNI, p<0.01). Age and baseline NIHSS were not associated with MNI. In a logistic regression model, favorable outcome at 90 days was independently associated with baseline NIHSS and MNI at discharge. Conclusions: MNI after intra-arterial therapy was seen in about a quarter of patients and was associated with higher CT ASPECT scores, time to therapy, and arterial recanalization. MNI at discharge was an independent predictor of long term outcome.

scholarly journals Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke

2021 ◽  
Vol 10 (14) ◽  
pp. 3005
Author(s):  
Marcin Wnuk ◽  
Justyna Derbisz ◽  
Leszek Drabik ◽  
Maciej Malecki ◽  
Agnieszka Slowik
Keyword(s):  
Ischemic Stroke ◽  
Fasting Glucose ◽  
Intravenous Thrombolysis ◽  
Favorable Outcome ◽  
Diabetic Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Glucose Levels

Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Importantly, formal analysis concerning the prognostic role of fasting glucose levels in these patients with and without diabetes mellitus (DM) was not performed. Therefore, we assessed whether fasting normoglycemia (FNG) next morning after AIS treated with IVT was associated with 90-day functional outcome in diabetic and non-diabetic patients. Methods: We retrospectively analyzed 362 AIS patients treated with IVT at The University Hospital in Krakow. FNG was defined as glucose below 5.5 mmol/L. A favorable outcome was defined as modified Rankin score (mRS) of 0–2 at day 90 after AIS onset. Results: At 3-month follow-up, FNG was associated with favorable outcome (87.5% vs. 60.8%, p < 0.001) and decreased risk of death (3.1% vs. 18.1%, p = 0.002). Independent predictors of a favorable outcome for the whole group were: younger age (HR 0.92, 95%CI 0.89–0.95), lower NIHSS score after IVT (HR 0.70, 95%CI 0.65–0.76), lower maximal systolic blood pressure within 24 h after IVT (HR 0.92, 95%CI 0.89–0.95) and FNG (HR 4.12, 95%CI 1.38–12.35). Association between FNG and mortality was found in univariable (HR 1.47, 95%CI 0.04–0.62) but not in multivariable analysis (HR 0.23, 95%CI 0.03–1.81). In subgroup analyses, FNG was an independent predictor of favorable outcome (HR 5.96, 95%CI 1.42–25.1) only in patients without DM. Conclusions: FNG next morning after IVT is an independent protective factor for a favorable long-term outcome in non-diabetic AIS patients.

Abstract TP448: High Residual Platelet Reactivity (hrpr) for Adenosine Diphosphate (adp) Stimuli is a Determinant Factor for Long-term Outcomes in Acute Ischemic Stroke With Anti-platelet Agents

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Jae-Kwan Cha ◽  
Eun-Kyu Kim
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Primary Endpoint ◽  
Platelet Reactivity ◽  
Large Artery ◽  
Vascular Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Platelet Aggregometry

Background and Purpose: High residual platelet activation (HRPA) after ADP stimuli has associated with recurrent vascular events in acute atherothrombosis with the use of antiplatelet agents (APAs). However, there has been little evidence supporting this association in acute ischemic stroke (AIS). In this study, we evaluated the influences of HRPR after ADP stimuli on the 1-year incidence of recurrent cardiovascular events and mortality in AIS with APAs. Methods: We conducted an observational, referral center cohort study on 968 AIS patients with APAs from January 2010 to December 2013 who were evaluated using optical platelet aggregometry (OPA). All patients received the dual APA combination of aspirin and clopidogrel or aspirin alone. We evaluated their platelet function 5 days after hospital admission using OPA. HRPR after ADP stimuli was defined as platelet aggregation of 70% or greater according to OPA after 10 μM ADP stimuli. Results: The primary endpoint was a composite of all causes of death, myocardial infarction, and stroke at the 1-year follow-up. The secondary endpoints were each component of the primary endpoint. The event rate of primary endpoint was 11.3% (109/968). Its rate was significantly higher in the patients with HRPR (16.7%) than in those without (9.7%). HPRP was independently associated with the primary endpoint (OR=1.97, CI 1.22 to 3.18, p<0.01). According to the AIS subtype, the presence of HRPR was independently significant for the occurrence of the primary endpoint in the large artery atherosclerosis (LAA) subtype only (OR=2.26, CI 1.15 to 4.45, P=0.02). Conclusions: In this study, the presence of HRPR after ADP stimuli is associated with a poor long-term outcome after acute ischemic stroke. In particular, the influence of this factor might be more prominent in LAA compared with other types of AIS.

Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis

Stroke ◽  
2014 ◽  
Vol 45 (10) ◽  
pp. 3070-3072 ◽  
Author(s):  
Marie Louise Schmitz ◽  
Claus Z. Simonsen ◽  
Heidi Hundborg ◽  
Hanne Christensen ◽  
Karsten Ellemann ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Term Outcome ◽  
Long Term Outcome

THE TYPE OF ATRIAL FIBRILLATION IS ASSOCIATED WITH LONG-TERM OUTCOME IN PATIENTS WITH ACUTE ISCHEMIC STROKE

2011 ◽  
Vol 22 ◽  
pp. S68-S69
Author(s):  
George Ntaios ◽  
Anastasia Vemmou ◽  
Eleni Koromboki ◽  
Paraskevi Savvari ◽  
Michalis Saliaris ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Term Outcome ◽  
Long Term Outcome

Long-term outcome changes after mechanical thrombectomy for anterior circulation acute ischemic stroke

2019 ◽  
Vol 267 (4) ◽  
pp. 1026-1034
Author(s):  
Hannah Fuhrer ◽  
Lisa Forner ◽  
Pascal Pruellage ◽  
Susanne Weber ◽  
Lena-Alexandra Beume ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Anterior Circulation ◽  
Term Outcome ◽  
Long Term Outcome

Prognostic Value of 24-H ABPM in Acute Ischemic Stroke for Short-, Medium-, and Long-Term Outcome: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 10 (7) ◽  
pp. 1000-1007 ◽  
Author(s):  
Nikolaos Kakaletsis ◽  
George Ntaios ◽  
Haralampos Milionis ◽  
Anna-Bettina Haidich ◽  
Konstantinos Makaritsis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Cardiac Baroreceptor Sensitivity Predicts Long-Term Outcome After Acute Ischemic Stroke

Stroke ◽  
2003 ◽  
Vol 34 (3) ◽  
pp. 705-712 ◽  
Author(s):  
Thompson G. Robinson ◽  
Suzanne L. Dawson ◽  
Penelope J. Eames ◽  
Ronney B. Panerai ◽  
John F. Potter
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Baroreceptor Sensitivity ◽  
Term Outcome ◽  
Long Term Outcome

Long-Term Outcome as Function of Blood Pressure in Acute Ischemic Stroke and Effects of Thrombolysis

2007 ◽  
Vol 24 (4) ◽  
pp. 349-354 ◽  
Author(s):  
Mei Yong ◽  
Hans-Christoph Diener ◽  
Markku Kaste ◽  
Jochen Mau
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Term Outcome ◽  
Long Term Outcome
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