Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27491738&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Stroke 2016 ; 47 (9): 2364-72 Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Leukoaraiosis, cerebral hemorrhage and outcome after IV thrombolysis for acute ischemic stroke: A meta-analysis (v1) #MMPMID27491738
Charidimou A; Pasi M; Fiorelli M; Shams S; von Kummer R; Pantoni L; Rost N
Stroke 2016[Sep]; 47 (9): 2364-72 PMID27491738show ga
Background-and-Purpose: We performed a meta-analysis to assess whether leukoaraiosis on brain CT scans of acute ischemic stroke patients treated with intravenous (IV) thrombolysis is associated with an increased risk of symptomatic intracerebral hemorrhage (sICH) and/or poor functional outcome at 3?6 months post-stroke. Methods: We searched PubMed and pooled relevant data in meta-analyses using random effects models. Using odds ratios (OR), we quantified the strength of association between the presence and severity of leukoaraiosis and post-thrombolysis sICH or 3?6 month modified Rankin Score (mRS) >2. Results: Eleven eligible studies (n=7194) were pooled in meta-analysis. The risk of sICH was higher in patients with leukoaraiosis (OR: 1.55; 95%CI: 1.17?2.06, p=0.002) and severe leukoaraiosis (OR: 2.53; 95%CI: 1.92?3.34, p<0.0001), compared to patients without leukoaraiosis. Leukoaraiosis was an independent predictor of sICH in six included studies (n=4976, adjusted-OR: 1.75, 95%CI: 1.35?2.27; p<0.0001). OR for leukoaraiosis and poor 3?6 month outcome was 2.02 (95%CI: 1.54?2.65, p<0.0001), with significant statistical heterogeneity (I2:75.7%, p=0.002). In adjusted analysed, leukoaraiosis was an independent predictor of poor outcome (n=3688, adjusted-OR: 1.61, 95%CI: 1.44?1.79; p<0.0001). In post-hoc analyses, including only leukoaraiosis patients in RCTs (IST-3, NINDS, ECASS-1-2; n=2234), tPA vs. control was associated with higher sICH risk (OR: 5.50; 95%CI: 2.49?12.13), but lower poor outcome risk (OR: 0.75; 95%CI: 0.60?0.95). Conclusions: Leukoaraiosis might increase post-IV thrombolysis sICH risk and poor outcome post-stroke. Despite increased sICH risk, IV tPA treatment has net clinical benefit in patients with leukoaraiosis. Given the risk of bias/confounding, these results should be considered hypothesis-generating and do not justify withholding IV thrombolysis.
free
free
free
Stroke 2016 ; 47 (9): 2364-72
