The Outcome of Treatment With Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke

Authors

  • Alia Saberi Neuroscience Research Center, Department of Neurology, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
  • Amirreza Ghayegran Department of Neurology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
  • Hamidreza Hatamian Department of Neurology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
  • Mojtaba Abbasalizade Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
  • Parisa Shahshahani Department of Neurology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
  • Samaneh Ghorbani Shirkouhi Neuroscience Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
  • Sasan Andalib Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
  • Zeinab Ehtiatkar Department of Neurology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Abstract:

Background: Thrombolytic therapy is the recommended treatment of acute ischemic stroke. It is crucial to evaluate the treatment results with recombinant Tissue Plasminogen Activator (r-TPA) in patients with acute stroke. Objectives: This study aimed to evaluate treatment outcomes with r-TPA in patients with acute stroke in a referral stroke center in Iran. Materials & Methods: In this retrospective study, 87 patients with symptoms of acute stroke were examined. They were referred to a stroke center in Gilan Province, Iran, from June 2016 to April 2020 and received r-TPA (0.9 mg/kg). Demographic information, the time interval between the onset of symptoms and r-TPA administration, complications, and National Institutes of Health Stroke Scale (NIHSS) upon arrival and discharge and death of patients were extracted from their hospital files. The paired t-test, independent t-test, and Pearson correlation test were used to compare variables using IBM SPSS for Windows version 20.0 (IBM Corp., Armonk, NY, USA). Results: The Mean±SD of NIHSS reduced from 14.7±6.4 to 8.9±7.6 (P<0.001). The most common complication was Intracerebral Hemorrhage (ICH) (12.6%). The hospital mortality rate was 23%. ICH occurred among 40% (n=8) of those who expired, and 4.47% (n=3) of them survived, and this difference was significant (P<0.001). Conclusion: The recovery with r-TPA administration in the stroke center was acceptable. Mortality and ICH occurrence rates were higher than other non-Iranian studies. It seems that we should change the case selection criteria and prescription dose to achieve better results of treatment with TPA.

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Journal title

volume 7  issue 3

pages  148- 156

publication date 2021-07

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