Tissue plasminogen activator (rt-PA) in acute ischemic stroke: Outcomes associated with ambulation

Area of Science:

• Neurology
• Cardiovascular Medicine
• Emergency Medicine

Background:

• Intravenous tissue type plasminogen activator (rt-PA) is a key treatment for acute ischemic stroke.
• Favorable outcomes are generally observed, with benefits being time-dependent.
• The impact of rt-PA on specific functional recovery, particularly ambulatory performance, requires further investigation.

Purpose of the Study:

• To investigate the association between early rt-PA treatment and changes in ambulatory status in acute ischemic stroke patients.
• To compare ambulatory outcomes between patients receiving rt-PA and those who did not.

Main Methods:

• Retrospective cohort analysis of acute ischemic stroke patients treated between 2010-2013.
• Inclusion criteria: rt-PA administration within 4.5 hours of symptom onset.
• Comparison of ambulatory variables and hospital characteristics between rt-PA and non-rt-PA groups.

Main Results:

• A statistically significant difference (P < 0.001) in ambulatory status improvement was observed between rt-PA recipients and non-recipients.
• Among rt-PA patients, 27.8% improved ambulation, 41.9% showed no change, and 0.4% worsened.
• In the non-rt-PA group, 20.1% improved ambulation, 61.8% showed no change, and 1.4% worsened.

Conclusions:

• Early administration of rt-PA in acute ischemic stroke is associated with improved ambulatory status from hospital admission to discharge.
• These findings highlight a potential benefit of rt-PA on patient mobility and functional recovery.
• Timely thrombolytic therapy may play a crucial role in enhancing post-stroke ambulatory outcomes.