Prestroke antiplatelet effect on symptomatic intracranial hemorrhage and functional outcome in intravenous thrombolysis

Jay Chol Choi, Ji Sung Lee, Tai Hwan Park, Yong Jin Cho, Jong Moo Park, Kyusik Kang, Kyung Bok Lee, Soo Joo Lee, Jae Guk Kim, Jun Lee, Man Seok Park, Kang Ho Choi, Joon Tae Kim, Kyung Ho Yu, Byung Chul Lee, Mi Sun Oh, Jae Kwan Cha, Dae Hyun Kim, Hyun Wook Nah, Dong Eog KimWi Sun Ryu, Beom Joon Kim, Hee Joon Bae, Wook Joo Kim, Dong Ick Shin, Min Ju Yeo, Sung Il Sohn, Jeong Ho Hong, Juneyoung Lee, Keun Sik Hong

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Purpose About 30%-40% of stroke patients are taking antiplatelet at the time of their strokes, which might increase the risk of symptomatic intracranial hemorrhage (SICH) with intravenous tissue plasminogen activator (IV-TPA) therapy. We aimed to assess the effect of prestroke antiplatelet on the SICH risk and functional outcome in Koreans treated with IV-TPA. Methods From a prospective stroke registry, we identified patients treated with IV-TPA between October 2009 and November 2014. Prestroke antiplatelet use was defined as taking antiplatelet within 7 days before the stroke onset. The primary outcome was SICH. Secondary outcomes were discharge modified Rankin Scale (mRS) score and in-hospital mortality. Results Of 1,715 patients treated with IV-TPA, 441 (25.7%) were on prestroke antiplatelet. Prestroke antiplatelet users versus non-users were more likely to be older, to have multiple vascular risk factors. Prestroke antiplatelet use was associated with an increased risk of SICH (5.9% vs. 3.0%; adjusted odds ratio [OR] 1.79 [1.05-3.04]). However, at discharge, the two groups did not differ in mRS distribution (adjusted OR 0.90 [0.72-1.14]), mRS 0-1 outcome (34.2% vs. 33.7%; adjusted OR 1.27 [0.94-1.72), mRS 0-2 outcome (52.4% vs. 52.9%; adjusted OR 1.21 [0.90-1.63]), and in-hospital mortality (6.1% vs. 4.2%; adjusted OR 1.19 [0.71-2.01]).

Original languageEnglish
Pages (from-to)344-351
Number of pages8
JournalJournal of Stroke
Volume18
Issue number3
DOIs
Publication statusPublished - 2016 Sep

Keywords

  • Outcome assessment
  • Platelet aggregation inhibitors
  • Stroke
  • Thrombolytic therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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    Choi, J. C., Lee, J. S., Park, T. H., Cho, Y. J., Park, J. M., Kang, K., Lee, K. B., Lee, S. J., Kim, J. G., Lee, J., Park, M. S., Choi, K. H., Kim, J. T., Yu, K. H., Lee, B. C., Oh, M. S., Cha, J. K., Kim, D. H., Nah, H. W., ... Hong, K. S. (2016). Prestroke antiplatelet effect on symptomatic intracranial hemorrhage and functional outcome in intravenous thrombolysis. Journal of Stroke, 18(3), 344-351. https://doi.org/10.5853/jos.2016.00185