Outcome after intravenous thrombolysis in patients with acute lacunar stroke: an observational study based on SITS international registry and a meta-analysis

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dc.authoridYakup Krespi / 0000-0001-5246-5908
dc.authorscopusidYakup Krespi / 7005049488
dc.contributor.authorMatusevicius, Marius
dc.contributor.authorPaciaroni, Maurizio
dc.contributor.authorCaso, Valeria
dc.contributor.authorBottai, Matteo
dc.contributor.authorKhurana, Dheeraj
dc.contributor.authorde Bastos, Mario
dc.contributor.authorMartins, Sheila C. O.
dc.contributor.authorKrespi, Yakup
dc.contributor.authorCooray, Charith
dc.contributor.authorToni, Danilo
dc.contributor.authorAhmed, Niaz
dc.date.accessioned2020-08-30T20:06:25Z
dc.date.available2020-08-30T20:06:25Z
dc.date.issued2019
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractBackground Intravenous thrombolysis (IVT) for lacunar stroke (LS) is debated, as the underlying pathophysiological mechanism may not be thrombogenic. Aims To investigate outcomes after IVT in LS in the SITS International Stroke Thrombolysis Register and perform a meta-analysis. Methods LS was identified by both baseline NIHSS-subscores and discharge ICD-10 codes, and contrasted by IVT to non-IVT treated. IVT patients were predominantly from Europe, non-IVT patients predominantly from South America and Asia. Outcome measurements were functional independence (modified Rankin Scale [mRS] score <= 2), excellent outcome (mRS <= 1), and mortality at three months. Matched-control comparisons of symptomatic intracerebral hemorrhage (SICH) between IVT-treated LS and IVT-treated non-LS patients were performed. Additionally, we performed a meta-analysis. Results Median age for IVT-treated LS patients (n = 4610) was 66 years vs. 64 years and NIHSS score was 6 vs. 3, compared to non-IVT-treated LS (n = 1221). Univariate outcomes did not differ; however, IVT-treated LS patients had higher adjusted odds ratios (aOR) for functional independence (aOR = 1.65, 95% CI = 1.28-2.13) but similar mortality at three months (aOR = 0.57, 0.29-1.13) than non-IVT-LS. Propensity-score matched analysis showed that IVT-treated LS patients had a 7.1% higher chance of functional independency than non-IVT LS patients (p < 0.001). IVT-treated LS patients had lower odds for SICH (aOR = 0.33, 0.19-0.58 per SITS, aOR = 0.40, 0.27-0.57 per ECASS-2) than matched non-LS controls, which was mirrored in the meta-analysis. Conclusions Our adjusted results show that IVT treatment in LS patients was associated with better functional outcome than non-IVT-treated LS and less SICH than IVT-treated non-LS patients.en_US
dc.identifier.citationMatusevicius, M., Paciaroni, M., Caso, V., Bottai, M., Khurana, D., de Bastos, M., … Ahmed, N. (2019). Outcome after intravenous thrombolysis in patients with acute lacunar stroke: An observational study based on SITS international registry and a meta-analysis. International Journal of Stroke. https://doi.org/10.1177/1747493019840947en_US
dc.identifier.doi10.1177/1747493019840947en_US
dc.identifier.endpage886en_US
dc.identifier.issn1747-4930en_US
dc.identifier.issn1747-4949en_US
dc.identifier.issue9en_US
dc.identifier.pmid30935349en_US
dc.identifier.scopus2-s2.0-85063896615en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage878en_US
dc.identifier.urihttps://doi.org/10.1177/1747493019840947
dc.identifier.urihttps://hdl.handle.net/20.500.12713/510
dc.identifier.volume14en_US
dc.identifier.wosWOS:000502477300012en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorKrespi, Yakupen_US
dc.language.isoenen_US
dc.publisherSage Publications Ltden_US
dc.relation.ispartofInternational Journal of Strokeen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectIschemic Strokeen_US
dc.subjectThrombolysisen_US
dc.subjectAcute Stroke Therapyen_US
dc.subjectIntracerebral Hemorrhageen_US
dc.subjectStroke Subtypesen_US
dc.subjectTpaen_US
dc.titleOutcome after intravenous thrombolysis in patients with acute lacunar stroke: an observational study based on SITS international registry and a meta-analysisen_US
dc.typeArticleen_US

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