The Risk of Intracranial Hemorrhage in Japanese Patients with Acute Large Vessel Occlusion; subanalysis of the RESCUE-Japan registry
The Risk of Intracranial Hemorrhage in Japanese Patients with Acute Large Vessel Occlusion; subanalysis of the RESCUE-Japan registry
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DOI：
10.1016/j.jstrokecerebrovasdis.2015.12.022
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发表时间：
2016-05-01
影响因子：
2.5
通讯作者：
Sakai, Nobuyuki
中科院分区：
文献类型：
--
作者：
Enomoto, Yukiko;Yoshimura, Shinichi;Sakai, Nobuyuki
背景：静脉溶栓（IVT）或血管内治疗（EVT）等再通疗法可改善急性缺血性卒中的结局；然而，它们存在颅内出血（ICH）的风险。本研究评估了日本急性大血管闭塞患者的脑出血发生率和预测因素。方法：超急性脑栓塞血管内抢救恢复-日本注册登记前瞻性登记了2010年7月至2011年6月期间在日本84个卒中中心收治的1442例发病后24小时内入院的伴有大血管闭塞的卒中患者。在这1442例患者中，纳入了1357例，以评估发病后24小时内ICH的发生率和预测因素。结果：284 名患者（20.9%）观察到 ICH。在这些患者中，46 例（3.4%）有症状性 ICH，其发生率在血管再通治疗（IVT 和/或 EVT）组中高于保守治疗组（4.5% vs 2.1%，P=0.013）。多变量分析显示，症状性 ICH 与治疗前抗血小板药物的使用和全身肝素化有关，与 IVT 和 EVT 均无关。结论：日本急性大血管闭塞患者的症状性 ICH 不受再通治疗或 EVT 本身的影响。
Background: Recanalization therapies such as intravenous thrombolysis (IVT) or endovascular treatment (EVT) improve acute ischemic stroke outcomes; however, they carry the risk of intracranial hemorrhage (ICH). The present study assessed the frequency and predictive factor of ICH in Japanese patients with acute large vessel occlusion. Methods: The Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism-Japan Registry prospectively registered 1442 stroke patients with major vessel occlusion who were admitted to 84 Japanese stroke centers within 24 hours after onset, from July 2010 to June 2011. Among these 1442 patients, 1357 were included to evaluate the incidence rate and predictive factors of ICH within 24 hours after onset. Results: ICH was observed in 284 (20.9%) patients. Among these patients, 46 (3.4%) had symptomatic ICH, and its incidence was higher in the recanalization therapy (IVT and/or EVT) group than in the conservative therapy group (4.5% versus 2.1%, P=.013). On multivariate analyses, symptomatic ICH was related to pretreatment antiplatelet agent use and systemic heparinization, and was related to neither IVT nor EVT. Conclusions: Symptomatic ICH was not affected by recanalization therapy or EVT itself in Japanese patients with acute large vessel occlusion.