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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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Clinical outcome of cardioembolic stroke treated by intravenous thrombolysis

D Vaclavik1, A Vilionskis2, D Jatuzis3

  • 1Department of Neurology, Ostrava Vitkovice Hospital, Agel Research and Training Institute, Ostrava, Czech Republic.

Acta Neurologica Scandinavica
|December 9, 2017
PubMed

Insights

Cardioembolic stroke (CS) patients treated with intravenous thrombolysis (IVT) do not face increased mortality. These patients show reduced risk of symptomatic intracranial hemorrhage and better outcomes post-IVT compared to other stroke types.

Area of Science:

  • Neurology
  • Cardiology
  • Stroke Medicine

Background:

  • Cardioembolic stroke (CS) historically presents worse outcomes and higher mortality without thrombolytic treatment compared to other stroke types.
  • Intravenous thrombolysis (IVT) is a critical treatment for acute ischemic stroke.
  • Understanding the specific outcomes of CS patients undergoing IVT is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To evaluate the clinical outcomes of patients with cardioembolic stroke (CS) who received intravenous thrombolysis (IVT).
  • To compare the outcomes of CS patients with other stroke etiologies treated with IVT.

Main Methods:

  • Analysis of data from the SITS-EAST register (2000-2014) for patients receiving IVT.
  • Categorization of stroke etiology using ICD-10 classification.
  • Assessment of outcomes including excellent clinical outcome (mRS 0-1 at 3 months), symptomatic intracranial hemorrhage (sICH), mortality, and early improvement (24 hours).
  • Univariate and multivariate analyses were employed to determine the effect of stroke etiology on outcomes.

Main Results:

  • A total of 13,772 patients were analyzed, with CS accounting for 30% of all strokes.
  • CS patients were older (mean age 70.8 years) and presented with more severe strokes (median NIHSS 13) compared to other etiologies.
  • No significant difference in mortality was observed between CS and atherothrombotic stroke.
  • CS patients demonstrated lower odds of symptomatic intracranial hemorrhage (sICH) and higher odds of early improvement and excellent clinical outcome after IVT compared to atherothrombotic stroke.

Conclusions:

  • Cardioembolic strokes (CS) treated with intravenous thrombolysis (IVT) are not associated with increased mortality.
  • Patients experiencing CS treated with IVT have a reduced likelihood of symptomatic intracranial hemorrhage (sICH).
  • CS patients treated with IVT generally experience better clinical outcomes compared to other stroke types.
Abstract

Keywords:
SITS registercardioembolic strokeoutcomethrombolysis

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