Acute stroke reperfusion therapy trends in the expanded treatment window era.
Acute stroke reperfusion therapy trends in the expanded treatment window era.
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DOI：
10.1016/j.jstrokecerebrovasdis.2014.04.023
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发表时间：
2014-10
影响因子：
2.5
通讯作者：
Lakshminarayan, Kamakshi
中科院分区：
文献类型：
--
作者：
Asaithambi, Ganesh;Tong, Xin;George, Mary G.;Tsai, Albert W.;Peacock, James M.;Luepker, Russell V.;Lakshminarayan, Kamakshi
The American Heart Association/American Stroke Association (AHA/ ASA) recommended an expansion of the time window for acute ischemic stroke (AIS) reperfusion with intravenous (IV) recombinant tissue plasminogen activator (rt-PA) from 3 to 4.5 hours after symptom onset. We examine rates of IV and intraarterial (IA) reperfusion before and after the recommendations to track guideline adoption in community practice. Patients with AIS in the Paul Coverdell National Acute Stroke Registry spanning years 2007-2012 were identified. Trends in rates of IV rt-PA versus IA therapy were examined. Outcomes included symptomatic intracerebral hemorrhage (sICH), in-hospital mortality, ability to ambulate at discharge, and discharge destination. From 2007 to 2012, there were 182,235 AIS patients (median age, 72 years; 51.5% women) in the database at the time of analysis. AIS patients receiving IV rt-PA increased significantly from 3.7% in 2007 to 5.1% in 2012 in the ≤3 hours time window and from .2% in 2007 to 1.3% in 2012 in the 3-4.5 hours time window (P <.001 for both). There was also a significant increase in the rate of IA therapy between 2007 and 2012 (P <.001). There was a significant decrease in the rate of sICH among patients who received any reperfusion between 2007 and 2012. There was a trend for increased utilization of IV rt-PA in the 0-3 hours and the 3-4.5 hours time windows, which began around the same time as the publication of AHA/ASA recommendations in 2009. This increase was associated with an increase in IA treatment rates along with a decrease in overall sICH rates for patients receiving any reperfusion. Key Words: Expanded time window—ischemic stroke—thrombolysis—trend analysis.
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DOI：
10.1016/j.apmr.2012.02.032
发表时间：
2012-08-01
影响因子：
4.3
作者：
Qureshi, Adnan I.;Chaudhry, Saqib A.;Suri, M. Fareed K.
通讯作者：
Suri, M. Fareed K.
影响因子：
158.5
作者：
Hacke, Werner;Kaste, Markku;Toni, Danilo
通讯作者：
Toni, Danilo
影响因子：
8.3
作者：
Wechsler, Lawrence R.;Jovin, Tudor G.
通讯作者：
Jovin, Tudor G.
DOI：
10.1056/nejmoa1214300
发表时间：
2013-03-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Broderick JP;Palesch YY;Demchuk AM;Yeatts SD;Khatri P;Hill MD;Jauch EC;Jovin TG;Yan B;Silver FL;von Kummer R;Molina CA;Demaerschalk BM;Budzik R;Clark WM;Zaidat OO;Malisch TW;Goyal M;Schonewille WJ;Mazighi M;Engelter ST;Anderson C;Spilker J;Carrozzella J;Ryckborst KJ;Janis LS;Martin RH;Foster LD;Tomsick TA;Interventional Management of Stroke (IMS) III Investigators
通讯作者：
Interventional Management of Stroke (IMS) III Investigators
影响因子：
8.3
作者：
Del Zoppo GJ;Saver JL;Jauch EC;Adams HP Jr;American Heart Association Stroke Council
通讯作者：
American Heart Association Stroke Council