The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients

Tai Hwan Park, Sang Soon Park, Youngchai Ko, Soo Joo Lee, Kyung Bok Lee, Jun Lee, Kyusik Kang, Jong Moo Park, Jay Chol Choi, Dong Eog Kim, Yong Jin Cho, Keun Sik Hong, Joon Tae Kim, Dae Hyun Kim, Jae Kwan Cha, Moon Ku Han, Ji Sung Lee, Juneyoung Lee, Kyung Ho Yu, Byung Chul Lee & 3 others Byung Woo Yoon, Hee Joon Bae, Gustavo Saposnik

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Despite substantial differences in clinical features between Asian and Western stroke patients, there are no published prognostic tools validated in an Asiatic population for thrombolytic therapy. We assessed the ability of the iScore to predict the clinical response after intravenous thrombolysis with tissue plasminogen activator (tPA) in a Korean stroke population. Methods We applied the iScore to eligible participants in the nationwide multicenter stroke registry in Korea. Main outcome measures were poor functional outcome defined as having a modified Rankin Scale score 3-6 and death at 3 months. Symptomatic intracranial hemorrhage (sICH) was evaluated as a safety outcome. C statistic was calculated to assess performance of iScore. Results Among 4760 patients with an acute ischemic stroke, 622 (13.1%) received tPA, 548 patients had complete information for the analysis. C statistics for poor functional outcome and death at 3 months were.813 (95% confidence interval [CI]:.778-.848) and.820 (95% CI:.769-.872), respectively. Overall, there was a high correlation between observed and expected outcome for poor functional outcome (Pearson correlation coefficient, r =.982) and for death at 3 months (r =.950) at the risk score level. An iScore of 180 or more was associated with a more than 2 times risk of poor functional outcome and about 6 times risk of death at 3 months. There was an interaction between the iScore and tPA for a poor functional outcome (P value for the interaction <.001). We found a gradient effect in the incident risk of sICH with the iScore. Conclusion The iScore reliably predicts stroke outcomes after tPA in Asiatic population.

Original languageEnglish
Pages (from-to)367-373
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume23
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

Fingerprint

Tissue Plasminogen Activator
Stroke
Intracranial Hemorrhages
Confidence Intervals
Population
Thrombolytic Therapy
Korea
Registries
Outcome Assessment (Health Care)
Safety

Keywords

  • ischemic stroke
  • prediction
  • Risk score
  • thrombolysis

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients. / Park, Tai Hwan; Park, Sang Soon; Ko, Youngchai; Lee, Soo Joo; Lee, Kyung Bok; Lee, Jun; Kang, Kyusik; Park, Jong Moo; Choi, Jay Chol; Kim, Dong Eog; Cho, Yong Jin; Hong, Keun Sik; Kim, Joon Tae; Kim, Dae Hyun; Cha, Jae Kwan; Han, Moon Ku; Lee, Ji Sung; Lee, Juneyoung; Yu, Kyung Ho; Lee, Byung Chul; Yoon, Byung Woo; Bae, Hee Joon; Saposnik, Gustavo.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 23, No. 2, 01.02.2014, p. 367-373.

Research output: Contribution to journalArticle

Park, TH, Park, SS, Ko, Y, Lee, SJ, Lee, KB, Lee, J, Kang, K, Park, JM, Choi, JC, Kim, DE, Cho, YJ, Hong, KS, Kim, JT, Kim, DH, Cha, JK, Han, MK, Lee, JS, Lee, J, Yu, KH, Lee, BC, Yoon, BW, Bae, HJ & Saposnik, G 2014, 'The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients', Journal of Stroke and Cerebrovascular Diseases, vol. 23, no. 2, pp. 367-373. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.05.025
Park, Tai Hwan ; Park, Sang Soon ; Ko, Youngchai ; Lee, Soo Joo ; Lee, Kyung Bok ; Lee, Jun ; Kang, Kyusik ; Park, Jong Moo ; Choi, Jay Chol ; Kim, Dong Eog ; Cho, Yong Jin ; Hong, Keun Sik ; Kim, Joon Tae ; Kim, Dae Hyun ; Cha, Jae Kwan ; Han, Moon Ku ; Lee, Ji Sung ; Lee, Juneyoung ; Yu, Kyung Ho ; Lee, Byung Chul ; Yoon, Byung Woo ; Bae, Hee Joon ; Saposnik, Gustavo. / The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients. In: Journal of Stroke and Cerebrovascular Diseases. 2014 ; Vol. 23, No. 2. pp. 367-373.
@article{e1f5fcc8cd6a407da5fbf3bfb7ac45ff,
title = "The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients",
abstract = "Background Despite substantial differences in clinical features between Asian and Western stroke patients, there are no published prognostic tools validated in an Asiatic population for thrombolytic therapy. We assessed the ability of the iScore to predict the clinical response after intravenous thrombolysis with tissue plasminogen activator (tPA) in a Korean stroke population. Methods We applied the iScore to eligible participants in the nationwide multicenter stroke registry in Korea. Main outcome measures were poor functional outcome defined as having a modified Rankin Scale score 3-6 and death at 3 months. Symptomatic intracranial hemorrhage (sICH) was evaluated as a safety outcome. C statistic was calculated to assess performance of iScore. Results Among 4760 patients with an acute ischemic stroke, 622 (13.1{\%}) received tPA, 548 patients had complete information for the analysis. C statistics for poor functional outcome and death at 3 months were.813 (95{\%} confidence interval [CI]:.778-.848) and.820 (95{\%} CI:.769-.872), respectively. Overall, there was a high correlation between observed and expected outcome for poor functional outcome (Pearson correlation coefficient, r =.982) and for death at 3 months (r =.950) at the risk score level. An iScore of 180 or more was associated with a more than 2 times risk of poor functional outcome and about 6 times risk of death at 3 months. There was an interaction between the iScore and tPA for a poor functional outcome (P value for the interaction <.001). We found a gradient effect in the incident risk of sICH with the iScore. Conclusion The iScore reliably predicts stroke outcomes after tPA in Asiatic population.",
keywords = "ischemic stroke, prediction, Risk score, thrombolysis",
author = "Park, {Tai Hwan} and Park, {Sang Soon} and Youngchai Ko and Lee, {Soo Joo} and Lee, {Kyung Bok} and Jun Lee and Kyusik Kang and Park, {Jong Moo} and Choi, {Jay Chol} and Kim, {Dong Eog} and Cho, {Yong Jin} and Hong, {Keun Sik} and Kim, {Joon Tae} and Kim, {Dae Hyun} and Cha, {Jae Kwan} and Han, {Moon Ku} and Lee, {Ji Sung} and Juneyoung Lee and Yu, {Kyung Ho} and Lee, {Byung Chul} and Yoon, {Byung Woo} and Bae, {Hee Joon} and Gustavo Saposnik",
year = "2014",
month = "2",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2013.05.025",
language = "English",
volume = "23",
pages = "367--373",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients

AU - Park, Tai Hwan

AU - Park, Sang Soon

AU - Ko, Youngchai

AU - Lee, Soo Joo

AU - Lee, Kyung Bok

AU - Lee, Jun

AU - Kang, Kyusik

AU - Park, Jong Moo

AU - Choi, Jay Chol

AU - Kim, Dong Eog

AU - Cho, Yong Jin

AU - Hong, Keun Sik

AU - Kim, Joon Tae

AU - Kim, Dae Hyun

AU - Cha, Jae Kwan

AU - Han, Moon Ku

AU - Lee, Ji Sung

AU - Lee, Juneyoung

AU - Yu, Kyung Ho

AU - Lee, Byung Chul

AU - Yoon, Byung Woo

AU - Bae, Hee Joon

AU - Saposnik, Gustavo

PY - 2014/2/1

Y1 - 2014/2/1

N2 - Background Despite substantial differences in clinical features between Asian and Western stroke patients, there are no published prognostic tools validated in an Asiatic population for thrombolytic therapy. We assessed the ability of the iScore to predict the clinical response after intravenous thrombolysis with tissue plasminogen activator (tPA) in a Korean stroke population. Methods We applied the iScore to eligible participants in the nationwide multicenter stroke registry in Korea. Main outcome measures were poor functional outcome defined as having a modified Rankin Scale score 3-6 and death at 3 months. Symptomatic intracranial hemorrhage (sICH) was evaluated as a safety outcome. C statistic was calculated to assess performance of iScore. Results Among 4760 patients with an acute ischemic stroke, 622 (13.1%) received tPA, 548 patients had complete information for the analysis. C statistics for poor functional outcome and death at 3 months were.813 (95% confidence interval [CI]:.778-.848) and.820 (95% CI:.769-.872), respectively. Overall, there was a high correlation between observed and expected outcome for poor functional outcome (Pearson correlation coefficient, r =.982) and for death at 3 months (r =.950) at the risk score level. An iScore of 180 or more was associated with a more than 2 times risk of poor functional outcome and about 6 times risk of death at 3 months. There was an interaction between the iScore and tPA for a poor functional outcome (P value for the interaction <.001). We found a gradient effect in the incident risk of sICH with the iScore. Conclusion The iScore reliably predicts stroke outcomes after tPA in Asiatic population.

AB - Background Despite substantial differences in clinical features between Asian and Western stroke patients, there are no published prognostic tools validated in an Asiatic population for thrombolytic therapy. We assessed the ability of the iScore to predict the clinical response after intravenous thrombolysis with tissue plasminogen activator (tPA) in a Korean stroke population. Methods We applied the iScore to eligible participants in the nationwide multicenter stroke registry in Korea. Main outcome measures were poor functional outcome defined as having a modified Rankin Scale score 3-6 and death at 3 months. Symptomatic intracranial hemorrhage (sICH) was evaluated as a safety outcome. C statistic was calculated to assess performance of iScore. Results Among 4760 patients with an acute ischemic stroke, 622 (13.1%) received tPA, 548 patients had complete information for the analysis. C statistics for poor functional outcome and death at 3 months were.813 (95% confidence interval [CI]:.778-.848) and.820 (95% CI:.769-.872), respectively. Overall, there was a high correlation between observed and expected outcome for poor functional outcome (Pearson correlation coefficient, r =.982) and for death at 3 months (r =.950) at the risk score level. An iScore of 180 or more was associated with a more than 2 times risk of poor functional outcome and about 6 times risk of death at 3 months. There was an interaction between the iScore and tPA for a poor functional outcome (P value for the interaction <.001). We found a gradient effect in the incident risk of sICH with the iScore. Conclusion The iScore reliably predicts stroke outcomes after tPA in Asiatic population.

KW - ischemic stroke

KW - prediction

KW - Risk score

KW - thrombolysis

UR - http://www.scopus.com/inward/record.url?scp=84893364007&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893364007&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2013.05.025

DO - 10.1016/j.jstrokecerebrovasdis.2013.05.025

M3 - Article

VL - 23

SP - 367

EP - 373

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 2

ER -