Effect of heparin on recanalization in acute stroke patients with intra-arterial thrombi

Anticoagulant use, such as heparin, is usually contraindicated in acute stroke patients. We present a study of patients, who were treated with intravenous heparin after a stroke that were also found to have an intraluminal thrombus. Prior studies imply that recanalization is achieved with heparin; however heparin should only prevent thrombus propagation. Therefore it is unclear whether and how IV heparin can achieve recanalization of intraluminal thrombi in acute stroke patients. A retrospective review of all acute stroke patients from a single stroke center who received a therapeutic IV heparin infusion from 5/2006 to 9/2011 were included in the study. We compared patients who had complete/partial recanalization and/or improved flow versus those that did not, with both these groups on a standard intravenous heparin infusion protocol. Demographic data was compared between the groups. Average partial thromboplastin time (PTT) during heparin infusion, time between computed tomography angiographies (CTAs), time from stroke onset to receiving IV heparin, and vessel occluded were also compared between groups. Forty-one patients (19 female, 22 male) were included in the study with a total of 55 vessels (either carotid, middle cerebral artery, anterior cerebral artery, posterior cerebral artery/posterior circulation) having intraluminal thrombi; 31 patients had 41 vessels with either partial or complete recanalization of effected vessels, while 10 patients had 14 vessels that did not have at least one vessel recanalize while on heparin. Using t-test we noted that the average PTT between the vessels that had partial/complete recanalization group (61.74) and non-recanalization group (66.30) was not statistical significantly different (P=0.37).The average time in days on heparin between vascular imaging studies (CTA/conventional angiogram) in the group of vessels with partial/complete recanalization (7.12 days) and the ones with no change (6.11 days) was not significantly different between the two groups (P=0.59). Patient’s vessels receiving heparin for <24 hours <em>versus</em> those >24 hours did not significantly differ either (P=0.17). This study compares patient characteristics associated with recanalization of intraluminal thrombi in acute stroke patients on heparin. Recanalization of intraluminal thrombi are not associated with average PTT or duration on heparin.

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Abstract TP310: Overcoming Barriers to Reduce Door to Needle Times in Acute Ischemic Stroke Patients: Field to CT

Stroke ◽

10.1161/str.47.suppl_1.tp310 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Spozhmy Panezai ◽

Florence Chukwuneke ◽

Audrey Arango ◽

Jaskiran Brar ◽

Joshua Daniel ◽

...

Keyword(s):

Acute Stroke ◽

Patient Outcomes ◽

Patient Characteristics ◽

Adverse Outcomes ◽

Ct Scanner ◽

Stroke Patients ◽

Stroke Team ◽

Presentation Time ◽

Comprehensive Stroke Center ◽

Stroke Center

Background: Time lost is brain lost. The ASA’s Target Stroke strategies were reviewed to improve Door to CT (DTCT) and Door to Needle (DTN) times. Taking acute stroke patients direct from triage to the CT scanner can reduce thrombolysis treatment times, which may improve patient outcomes. In April 2015, the JFK Comprehensive Stroke Center introduced a Direct to CT policy for acute stroke patients who are assessed to be acute by the JFK EMS service. Method: We performed a prospective pilot study comparing door-to-CT times (DTCT) and door-to-needle (DTN) times pre- and post-implementation of Direct to CT policy, and analyzed patient characteristics, Emergency Department (ED) presentation time, adverse effects, protocol violations and patient outcomes. Delays in treatment, enablers and barriers to treatment were also examined. The purpose was to look at feasibility and maintenance of quality when applied to a larger subset of patients. Results: There was no statistical difference in demographics or clinical factors in patients who presented pre- (2013, 2014, n= 621) or post- Direct to CT (April 20-June 20, 2015 n=22). However, a reduction in mean DTCT times (21 mins vs. 8.7 mins, p<.0001) and DTN times (55 mins vs. 19 mins, p<.0001) was seen. There was no increase in adverse outcomes (7% vs. 0%) in patients taken Direct to CT. There was no difference in patient outcomes, however the current study size is small. Numerous barriers to Direct to CT were identified at the pre-hospital, ED, CT and stroke team levels. These issues included ED resources, hospital geography and space, and stroke team decision making. Some of these concerns are ongoing and will take time and effort to overcome. Strengths noted were the EMS capability of pre-hospital Intravenous line establishment, blood draws, and EKG performance as well as IV tPA initiation in the CT area. Conclusions: Taking patients Direct to CT has significantly reduced time to evaluation, DTCT, and DTN and further improvements may be achieved through resolution of identified barriers.

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Abstract WP279: Concordance of Paramedic and Hospital Documented Last Known Well Times for EMS Transported Acute Ischemic Stroke Patients

Stroke ◽

10.1161/str.48.suppl_1.wp279 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Lucas Ramirez ◽

Nichole Bosson ◽

Marianne Gausche-Hill ◽

Jeffery L Saver ◽

Sid Starkman ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Stroke ◽

Patient Characteristics ◽

Final Diagnosis ◽

Multivariate Regression Analysis ◽

Stroke Patients ◽

Hospital Arrival ◽

Median Difference ◽

Suspected Stroke ◽

Stroke Center

Background: Last known well time (LKWT) is increasingly used by EMS systems to identify acute stroke patients appropriate for direct routing to Stroke Centers. However, determining LKWT in the field is challenging, as patients may be aphasic, witnesses may not be available on scene, and rapid departure from the scene is desirable. Objective: To characterize the concordance and degree of discordance between prehospital-determined LKWT and final LKWT documented at the hospital. Methods: This is a retrospective analysis of consecutive patients with positive prehospital stroke screens transported to an approved stroke center in a large metropolitan system from January 2011 to December 2014. Data was abstracted from the regional EMS Agency stroke database. Patients with missing prehospital or hospital documentation of LKWT were excluded. The percent concordance and the median difference were calculated for prehospital versus final hospital documented LKWT. The effect of patient characteristics on discordance was also explored via multivariate regression analysis. Result: Among the 9,810 patients transported for suspected stroke, the median age was 75 (Interquartile range [IQR] 62-85) years, 53% were women, 67% White, 11% Asian, 9% Black and 27% Hispanic. The median NIHSS was 11 (IQR 4 to 20). 83% had a cerebrovascular final diagnosis, ischemic stroke (IS) being the most common (n=5160, 53%), whereas 17% had a non-stroke-related diagnosis. There were 6873 patients missing either prehospital or hospital documentation of LKWT leaving 9810 patients for the analysis. Prehospital and hospital documented LKWTs were exactly equal in 42% of patients (36% for IS), within 15 minutes in 53% (48% for IS), within 1 hour in 66% (63% in IS) and within 2 hours in 70% (68% in IS). The median difference in LKWT between documented prehospital and hospital values was 0 minutes (IQR -6 to 18). The degree of discordance in LKWT did not vary with patient sex, race, or Hispanic ethnicity. Conclusions: Paramedic-documented LKWT was within 15 minutes of the final hospital documented LKWT in just over half of acute stroke EMS transports and within 1 hour in two-thirds.. As accurate LKWT determination in the field is challenging, time of symptom onset should be confirmed after hospital arrival.

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In-Hospital Intravenous Thrombolysis Offers No Benefit in Mechanical Thrombectomy in Optimized Tertiary Stroke Center Setting

CardioVascular and Interventional Radiology ◽

10.1007/s00270-020-02727-8 ◽

2020 ◽

Author(s):

Juha-Pekka Pienimäki ◽

Jyrki Ollikainen ◽

Niko Sillanpää ◽

Sara Protto

Keyword(s):

Clinical Outcome ◽

Acute Stroke ◽

Mechanical Thrombectomy ◽

Clinical Laboratory ◽

Intravenous Thrombolysis ◽

Stroke Patients ◽

Anterior Circulation ◽

Vessel Occlusion ◽

Ordinal Logistic Regression Analysis ◽

Stroke Center

Abstract Purpose Mechanical thrombectomy (MT) is the first-line treatment in acute stroke patients presenting with large vessel occlusion (LVO). The efficacy of intravenous thrombolysis (IVT) prior to MT is being contested. The objective of this study was to evaluate the efficacy of MT without IVT in patients with no contraindications to IVT presenting directly to a tertiary stroke center with acute anterior circulation LVO. Materials and Methods We collected the data of 106 acute stroke patients who underwent MT in a single high-volume stroke center. Patients with anterior circulation LVO eligible for IVT and directly admitted to our institution who subsequently underwent MT were included. We recorded baseline clinical, laboratory, procedural, and imaging variables and technical, imaging, and clinical outcomes. The effect of intravenous thrombolysis on 3-month clinical outcome (mRS) was analyzed with univariate tests and binary and ordinal logistic regression analysis. Results Fifty-eight out of the 106 patients received IVT + MT. These patients had 2.6-fold higher odds of poorer clinical outcome in mRS shift analysis (p = 0.01) compared to MT-only patients who had excellent 3-month clinical outcome (mRS 0–1) three times more often (p = 0.009). There were no significant differences between the groups in process times, mTICI, or number of hemorrhagic complications. A trend of less distal embolization and higher number of device passes was observed among the MT-only patients. Conclusions MT without prior IVT was associated with an improved overall three-month clinical outcome in acute anterior circulation LVO patients.

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Abstract 2903: Nutritional Access of Dysphagic Patients 3 Months after Onset of Acute Stroke -From Database of 5,000 Patients in a Single Stroke Center-

Stroke ◽

10.1161/str.43.suppl_1.a2903 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Makoto Nakajima ◽

Yuichiro Inatomi ◽

Toshiro Yonehara ◽

Yoichiro Hashimoto ◽

Teruyuki Hirano

Keyword(s):

Acute Stroke ◽

Chronic Phase ◽

Oral Intake ◽

Continuous Variables ◽

Operating Characteristics ◽

Stroke Patients ◽

Nihss Score ◽

Swallowing Dysfunction ◽

Stroke Center ◽

Dysphagic Patients

Background and purpose: Prediction of swallowing function in dysphagic patients with acute stroke is indispensable for discussing percutaneous endoscopic gastrostomy (PEG) placement. We performed a retrospective study using database of a large number of acute ischemic stroke patients to clarify predictors for acquisition of oral intake in chronic phase. Methods: A total 4,972 consecutive acute stroke patients were admitted to our stroke center during 8.5 years; a questionnaire was sent to all the survivors after 3 months of onset. We investigated nutritional access after 3 months of onset in 588 patients who could not eat orally 10 days after admission, and analyzed predictive factors for their acquisition of oral intake. Continuous variables were dichotomized to identify the most sensitive predictors; the cutoff values were investigated by receiver operating characteristics curve analysis. Results: Out of 588 dysphagic patients, 75 died during the 3 months, and 143 (28%) of the residual 513 achieved oral intake after 3 months. In logistic-regression models, age ≤80 years, absence of hyperlipidemia, absence of atrial fibrillation, modified Rankin Scale score 0 before onset, and low National Institutes of Health Stroke Scale (NIHSS) score independently predicted oral intake 3 months after onset. From two different model analyses, NIHSS score ≤17 on day 10 (OR 3.63, 95% CI 2.37-5.56) was found to be a stronger predictor for oral intake than NIHSS score ≤17 on admission (OR 2.34, 95% CI 1.52-3.59). At 3 months, 17/143 (12%) patients with oral intake were living at home, while only 1/370 (0.3%) patients without oral intake were. Conclusion: A quarter of dysphagic patients with acute stroke obtained oral intake 3 months after onset. Clinicians should be cautious about PEG placement for stroke patients with severe dysphagia who were independent prior to the stroke, aged ≤80 years, and show NIHSS score ≤17 on day 10, because their swallowing dysfunction may improve in a few months.

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Abstract 166: Spleen Contraction in Patients With Ischemic Stroke and Brain Hemorrhage: Validating Animal Studies

Stroke ◽

10.1161/str.46.suppl_1.166 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Farhaan S Vahidy ◽

Mohammad H Rahbar ◽

MinJae Lee ◽

Kaushik N Parsha ◽

Preeti Sahota ◽

...

Keyword(s):

Acute Stroke ◽

Symptom Onset ◽

Animal Studies ◽

Brain Hemorrhage ◽

Stroke Patients ◽

Consecutive Period ◽

Spleen Contraction ◽

History Of ◽

And Gender ◽

Stroke Center

Objectives: Animal models have shown that the spleen contracts and contributes to post-ischemic inflammation that may exacerbate brain injury and impair recovery. Translation of these findings in patients is challenging because of a lack of normative spleen volume (SV) data. We created normograms of SV for an adult at-risk population, quantified splenic contraction (SC) in stroke patients, and characterized patients with SC. Methods: We enrolled 158 healthy volunteers (HV) with matching age and gender distribution with that of our stroke center registry. Spleen ultrasounds were performed on 5 consecutive days. We used quantile regression models to identify predictors of SV for HV. Gender and body surface area (BSA) were used to construct percentile based normograms of SV, and the expected pre-stroke SV were calculated, from which SC was quantified. We also enrolled a cohort of 170 patients with acute stroke and intracerebral hemorrhage within 24 hours of symptom onset and performed serial spleen ultrasound measurements during hospitalization. Logistic regression was used to determine factors associated with SC. Results: Normograms for SV in healthy males and females based on BSA were created (Figure 1). Over a 5-day consecutive period of daily spleen measurements, the maximum day to day variation was 10.6 cm3. Based on these findings, stroke patients with a normalized SV below 20 cm3 of their expected SV, were classified as having SC. Excluding stroke mimics, 158 patients were included in the analyses, of which 64 (40.5%) had SC detected within 24 hrs of symptom onset. African-American race, older age, and history of previous stroke were significantly associated with SC (Table 1). Conclusion: The spleen does appear to reduce in size after stroke in some specific subgroups of patients with acute stroke and brain hemorrhage. The biological relevance of SC to the inflammatory response and functional outcomes of stroke patients are currently being studied in our study cohorts.

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Abstract T P267: Development of an EMS Interfacility Ground Transport Protocol for Patients During/After IV tPA Administration for Acute Ischemic Stroke

Stroke ◽

10.1161/str.45.suppl_1.tp267 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Kerrin Connelly ◽

Rishi Gupta ◽

Raul Nogueira ◽

Arthur Yancey ◽

Alexander Isakov ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Stroke ◽

Acute Ischemic Stroke ◽

Transport Protocol ◽

Stroke Patients ◽

Stroke Registry ◽

The Public ◽

State Office ◽

Stroke Center ◽

Iv Tpa

Purpose: To standardize the care of acute stroke patients who receive IV tPA being transported by ground EMS from a treating hospital to a stroke center. Background: National consensus guidelines exist for the hospital management of patients receiving IV tPA for acute ischemic stroke. Such patients require close monitoring and management to minimize risk of clinical deterioration. Although patients are often emergently transported from local hospitals to a stroke center, there are no treatment specific national guidelines for managing such patients enroute. As a result, there is a need to develop and implement a standardized approach to guide EMS personnel, particularly in states like Georgia where the public health burden of stroke is high. Methods: In 2012, the “Georgia EMS Interfacility Ground Transport Protocol for Patients during/after IV tPA Administration for Acute Ischemic Stroke” was developed in conjunction with the Georgia Coverdell Acute Stroke Registry, the Georgia State Office of EMS, a representative group of Georgia hospitals and EMS providers. Stakeholders were brought together with the goal of creating a unified statewide protocol. The intent was to create a streamlined protocol which could be readily implemented by pre-hospital care providers. Results: Stakeholders discussed challenges and opportunities to change the process of pre-hospital care. Challenges included recognition of the broad diversity of EMS providers representing over 250 agencies in the state. Opportunities included establishing the framework for greater collaboration across organizations and providers. The final protocol was endorsed by both the Georgia Coverdell Acute Stroke Registry and the State Office of EMS, and distributed to all EMS regions in Georgia. EMS agencies are currently implementing the protocol. Conclusion: Engaging a diverse group of statewide stakeholders to develop a new treatment protocol enhances success in implementation and serves to further the public health mission of improving care of acute stroke patients.

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Abstract P855: Importance of Compliance in Dysphagia Screening in Acute Stroke Care

Stroke ◽

10.1161/str.52.suppl_1.p855 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Patty Noah ◽

Melanie Henderson ◽

Rebekah Heintz ◽

Russell Cerejo ◽

Christopher T Hackett ◽

...

Keyword(s):

Acute Stroke ◽

Aspiration Pneumonia ◽

Hemorrhagic Stroke ◽

Oral Intake ◽

Stroke Care ◽

Stroke Severity ◽

Stroke Patients ◽

Acute Stroke Care ◽

Chi Square ◽

Stroke Center

Introduction: Dysphagia occurs in up to two thirds of stroke patients and can lead to serious complications such as aspiration pneumonia, which is also linked to increased morbidity and mortality. Evidence-based guidelines recommend a bedside dysphagia assessment before oral intake in stroke patients regardless of initial stroke severity. Several studies have described registered nurses’ competency in terms of knowledge and skills regarding dysphagia screening. We aimed to examine the rate of aspiration pneumonia compared to the rate of dysphagia screening. Methods: A retrospective analysis of prospectively collected data at a single tertiary stroke center was carried out between January 2017 and June 2020. Data comparison was completed utilizing ICD-10 diagnosis codes to identify aspiration pneumonia in ischemic and hemorrhagic stroke patients. The data was reviewed to compare the compliance of a completed dysphagia screen prior to any oral intake to rate of aspiration pneumonia. Chi square tests were used to assess proportion differences in completed dysphagia screen and proportion of aspiration pneumonia diagnosis in the ischemic and hemorrhagic stroke patients. Results: We identified 3320 patient that met inclusion criteria. 67% were ischemic strokes, 22% were intracerebral hemorrhages and 11% were subarachnoid hemorrhages. Compliance with dysphagia screening decreased from 94.2% (n=1555/1650) in 2017-2018 to 74.0% (n=1236/1670) in 2019-2020, OR=0.17 (95%CI 0.14 - 0.22), p < 0.0001. Aspiration pneumonias increased from 58 (3.5%) in 2017-2018 to 77 (4.6%) in 2019-2020, but this difference was not statistically significant, OR=0.75 (95%CI 0.53 - 1.07), p = 0.11. Conclusion: We noted that the decrease in compliance with completing a dysphagia screen in patients with acute stroke prior to any oral intake was associated with a higher trend of aspiration pneumonia.

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Abstract TP383: Ischemic Stroke Patients With Diabetes Looking for Practices in Need of Improvement

Stroke ◽

10.1161/str.51.suppl_1.tp383 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Cynthia Bautista ◽

Sally Gerard

Keyword(s):

Ischemic Stroke ◽

Cause Of Death ◽

Demographic Data ◽

Stroke Care ◽

The United States ◽

Stroke Patients ◽

Co Morbidity ◽

Patients With Diabetes ◽

Care Outcomes ◽

Stroke Center

Background/Purpose: Stroke is the fifth leading cause of death and Diabetes is the seventh leading cause of death in the United States. Diabetes is an independent risk factor for stroke. Diabetes is a common co-morbidity in stroke patients and is associated with poor outcomes after stroke. Get with the Guidelines - Stroke (GWTG-S) Registry database provides a rich opportunity to look at disease-specific data and find opportunities for improving care. The purpose of this study was to examine specific elements of acute ischemic stroke care in patients with diabetes using the GWTG-S at Comprehensive and Primary Stroke Centers in Northeast of America. Methods: A retrospective, descriptive study at both a Comprehensive and Primary Stroke Center. The analysis focused on patients with ischemic stroke and diabetes entered in the GWTG-S from January 1, 2015, to December 31, 2017. Data were analyzed looking at measures specific to stroke and the presence of diabetes. General demographic data were examined to compare populations and quality outcome measures. Results: The sample of patients with ischemic stroke and diabetes was over 1,000 patient’s at the two sites (Comprehensive site N = 804, Primary site N = 203) Incidence of ischemic stroke with diabetes at the two sites were 32% and 26%, respectively. Demographic data were similar in most categories including age, race, and gender. Significant differences were found in regard to the type of insurance. Stroke care outcomes indicated thrombolytic administration rates were the same at 8%. Diabetes care outcomes indicated patients discharged on insulin occurred in 18% to 26% of the sample. Conclusion/Implications for Practice: Ischemic stroke patients with diabetes were shown to receive similar care at both a comprehensive and primary care stroke center. There were no differences between centers in thrombolysis treatment for ischemic stroke patients with diabetes. Several opportunities for improvement in diabetes-related care need to be addressed.

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Abstract T MP75: Facilities Available in Chinese Hospitals From China Stroke Research Network

Stroke ◽

10.1161/str.46.suppl_1.tmp75 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Chunjuan Wang ◽

Zixiao Li ◽

Yilong Wang ◽

Yong Jiang ◽

Xingquan Zhao ◽

...

Keyword(s):

Acute Stroke ◽

Mainland China ◽

Stroke Care ◽

Research Network ◽

Level Of Care ◽

Minimum Level ◽

Stroke Patients ◽

Stroke Research ◽

Primary Stroke Center ◽

Stroke Center

Background and Purpose: Stroke is the first leading cause of death in China and millions of patients were admitted to various levels of hospitals each year. However, it is unknown how many of these hospitals are able to provide an appropriate level of care for stroke patients since the certification program of comprehensive stroke center (CSC) and primary stroke center (PSC) has not been initiated in China. Method: In 2012, we selected all 554 hospitals that joined into the China Stroke Research Network (CSRN) to start a survey. These hospitals were from 31 provinces or municipalities, covered nearly the entire Mainland China. A six-page questionnaire was sent to each of them to obtain the stroke facility information. We used the same criteria and definitions for CSC, PSC, and minimum level for any hospital ward (AHW) admitting stroke patients with that of the European Stroke Facilities Survey. Results: For all the hospitals in CSRN, 521 (94.0%) returned the questionnaire, 20 (3.8%) met criteria for CSC, 179 (34.4%) for PSC, 64 (12.3%) for AHW, and 258 (49.5%) met none of them and provided a lower level of care. Hospitals meeting criteria for CSC, PSC, AHW, and none of them admitted 70 052 (8.8%), 334 834 (42.2%), 88 364 (11.1%), and 299 806 (37.8%) patients in the whole of last year. There was no 24-hour availability for brain CT scan in 4.3% of hospitals not meeting criteria for AHW, while neither stroke care map nor stroke pathway for patients admission in 81.0% of them. Conclusions: Less than two fifths of Chinese hospitals admitting acute stroke patients have optimal facilities, and nearly half even the minimum level is not available. Our study suggests that only one half acute stroke patients are treated in appropriate centers in China, facilities for hospitals admitting stroke patients should be enhanced and certification project of CSCs and PSCs may be a feasible choice.

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Evaluating the Role of Oxidative Stress in Acute Ischemic Stroke

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0039-3402675 ◽

2020 ◽

Vol 11 (01) ◽

pp. 156-159

Author(s):

Bindu Menon ◽

Krishnan Ramalingam ◽

Rajeev Kumar

Keyword(s):

Oxidative Stress ◽

Ischemic Stroke ◽

Acute Stroke ◽

Acute Ischemic Stroke ◽

Lipid Membranes ◽

Demographic Data ◽

Stroke Severity ◽

Stroke Patients ◽

Antioxidant Power

Abstract Background The role of oxidative stress in neuronal injury due to ischemic stroke has been an interesting topic in stroke research. Malondialdehyde (MDA) has emerged as a sensitive oxidative stress biomarker owing to its ability to react with the lipid membranes. Total antioxidant power (TAP) is another biomarker to estimate the total oxidative stress in stroke patients. We aimed to determine the oxidative stress in acute stroke patients by measuring MDA and TAP. Materials and Methods MDA and TAP were determined in 100 patients with ischemic stroke and compared with that in 100 age- and sex-matched healthy adults. Demographic data, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), and disability measured by the Barthel index (BI) were recorded. The association of MDA and TAP with other variables was analyzed by paired t-test. Results Of the whole sample, 74% represented males. The mean NIHSS score was 13.11 and BI was 38.87. MDA was significantly higher in stroke patients (7.11 ± 1.67) than in controls (1.64 ± 0.82; p = 0.00). TAP was significantly lower in stroke patients (5.72 ± 1.41) than in controls (8.53 ± 2.4; p = 0.00). The lipid profile and blood sugar levels were also significantly higher in stroke patients. There was no association of MDA and TAP with other variables. Conclusion We found that oxidative stress was associated with acute ischemic stroke. However, we could not establish an association between oxidative stress and the severity of acute stroke.

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