One-Year Outcomes After Intravenous Recombinant Tissue Plasminogen Activator for Ischemic Stroke: A Real-World Study

Area of Science:

• Neurology
• Cardiovascular Medicine
• Public Health

Background:

• Limited data exists on the long-term benefits of intravenous recombinant tissue plasminogen activator (IV rt-PA) for Chinese patients with acute ischemic stroke (AIS).
• Real-world evidence is crucial for understanding the effectiveness of IV rt-PA in diverse patient populations.

Purpose of the Study:

• To evaluate the 1-year clinical outcomes of IV rt-PA treatment in Chinese AIS patients.
• To compare functional outcomes and mortality between IV rt-PA treated and non-reperfusion groups.

Main Methods:

• Prospective multicenter stroke registry data from 80 centers in China (January 2017-March 2020).
• Analysis of AIS patients (aged ≥18 years) within 4.5 hours of symptom onset.
• Propensity score matching (1:1) of IV rt-PA treated patients with non-reperfusion patients based on baseline characteristics.

Main Results:

• One-year all-cause mortality was similar between groups (11.1% vs. 12.2%, p=0.183).
• IV rt-PA group showed higher functional independence (mRS 0-2: 70.9% vs. 66.4%, p<0.001) and favorable outcomes (mRS 0-1: 59.5% vs. 54.6%, p<0.001).
• Lower rates of severe disability/death (mRS 5-6) were observed in the IV rt-PA group (15.9% vs. 20.3%, p<0.001).

Conclusions:

• IV rt-PA treatment is associated with improved 1-year functional outcomes in eligible Chinese AIS patients.
• The benefits in functional recovery are achieved without an increase in mortality compared to no reperfusion therapy.