Title:Effect of Cardioembolic Etiology on Intravenous Thrombolysis Efficacy for Acute Ischemic Stroke
Volume: 13
Issue: 3
Author(s): Sabrina Anticoli, Maria Cristina Bravi, Giovanni Perillo, Antonio Siniscalchi, Claudio Pozzessere, Francesca Romana Pezzella, Piero Tanzi, Luca Gallelli and Domenico Cartoni
Affiliation:
Keywords:
rt-PA, cardioembolic stroke, non-cardioembolic stroke, PFO-Stroke patients, symptoms improvement, symptoms
regression.
Abstract: Previous clinical studies suggest that intravenous (IV) recombinant tissue plasminogen activator (rt-PA) benefits
stroke patients regardless of the underlying etiology. In this study, we assessed the possible differences in response to
IV rt-PA between cardioembolic stroke and other stroke subtypes. A total of 303 consecutive stroke ischemic patients
(from January 2005 to April 2014) admitted to our Stroke Unit and treated with IV rt-PA were retrospectively reviewed.
All patients were classified in two groups: Cardioembolic (CE) and Non-Cardioembolic (NCE). We analyzed a total of
303 patients. Thirty patients died in the first hours after fibrinolysis and no statistically significant differences were found
in two groups (14 CE vs 18 N-CE). We observed a significant differences in clinical outcome in terms of symptoms ”improvement”
(p<0.01 2) and symptoms” regression” (p<0.057 2) even if this last result did not reach statistical significance
in CE patients respect to N-CE patients.
In conclusion, the intravenous fibrinolysis is more effective in CE group than in N-CE regarding symptoms ”improvement”
and the PFO-Stroke patients treated with fibrinolysis have better outcome than other patients and they have high
rate of symptoms” regression”. Moreover the main predictor of good outcomes were younger age and milder stroke severity
on hospital admission.
