Low-dose rt-PA may not decrease the incidence of symptomatic intracranial haemorrhage in patients with high risk of symptomatic intracranial haemorrhage
机构：[1]Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China[2]Center of Stroke, Beijing Tiantan Hospital, Capital Medical University, Beijing, China首都医科大学附属天坛医院[3]National Clinical Research Center for Neurological Diseases, Beijing, China[4]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China[5]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China[6]Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China[7]Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
Background: Recombinant tissue plasminogen activator (rt-PA) has been used as the standard treatment for acute ischemic stroke (AIS). The following study investigates whether low-dose rt-PA can decrease the incidence of symptomatic intracranial haemorrhage (sICH) in AIS patients with high-risk sICH compared to standard-dose rt-PA. Materials and Methods: Data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) studies were assessed to explore risk factors for sICH after intravenous thrombolysis. For high-risk sICH patients (age >= 70 years old, or with diabetes, or serum glucose on admission >9.0 mmol/L, or NIHSS on admission>20, or with cardioembolism), standard-dose rt-PA (0.85 to 0.95 mg/kg) and low- dose rt-PA (0.5 to 0.7 mg/kg) were compared. Primary outcome measure was the incidence of sICH, and the secondary outcome measures were 7-day mortality and 90-day functional independence outcome (modified Rankin scale, 0-2). Results: A total of 554 patients were enrolled (60 cases for low dose, and 494 cases for standard dose). Median rt-PA doses were 0.63 and 0.90 mg, respectively. After adjustment for the baseline variables, low-dose rt-PA did not decrease the incidence of sICH (per SITS-MOST criteria, 3.33% versus 2.23%, P = 0.3467) compared to low dose. The low-dose group revealed less functional independence outcomes (modified Rankin scale, 0-2) compared to standard-dose group (36.67% versus 52.43%; odds ratio = 0.49; p = 0.0204) at 90 days. Conclusions: Our study suggests that low-dose intravenous rt-PA for high-risk sICH stroke in Chinese patients may not decrease the incidence of sICH, and concomitant with a poor outcome compared to standard-dose rt-PA.
基金：
National Science and Technology Major Project of China [2011BAI08B02]; State Key Development Program of Basic Research of ChinaState Key Development Program for Basic Research of China [2009CB521905]
第一作者机构：[1]Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
通讯作者：
通讯机构：[1]Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China[*1]Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100054, China
推荐引用方式(GB/T 7714)：
Liu Mingyong,Pan Yuesong,Zhou Lichun,et al.Low-dose rt-PA may not decrease the incidence of symptomatic intracranial haemorrhage in patients with high risk of symptomatic intracranial haemorrhage[J].NEUROLOGICAL RESEARCH.2019,41(5):473-479.doi:10.1080/01616412.2019.1580454.
APA：
Liu, Mingyong,Pan, Yuesong,Zhou, Lichun&Wang, Yongjun.(2019).Low-dose rt-PA may not decrease the incidence of symptomatic intracranial haemorrhage in patients with high risk of symptomatic intracranial haemorrhage.NEUROLOGICAL RESEARCH,41,(5)
MLA：
Liu, Mingyong,et al."Low-dose rt-PA may not decrease the incidence of symptomatic intracranial haemorrhage in patients with high risk of symptomatic intracranial haemorrhage".NEUROLOGICAL RESEARCH 41..5(2019):473-479
