title: Prior use of antiplatelet therapy can be associated with a higher chance for early recanalization of the occluded middle cerebral artery in acute stroke patients treated with intravenous thrombolysis.
abstract: BACKGROUND
  The early recanalization (ER) of an occluded cerebral artery is important for clinical improvement in acute ischemic stroke. The aim of the study was to assess the possible association between the prior use of antiplatelets (AP) and ER of occluded middle cerebral artery (MCA) after intravenous thrombolysis (IVT).
  
  
  METHODS
  In 146 consecutive acute ischemic stroke patients presenting with occluded MCA and treated with IVT, the ER and incidence of symptomatic intracerebral hemorrhage (SICH) were compared according to the presence or absence of prior AP use. ER was assessed by transcranial Doppler or digital subtraction angiography within 2 h after the end of IVT.
  
  
  RESULTS
  Fifty-six patients (28 males, mean age: 69.8 ± 9.8 years) used AP and 90 patients were AP naïve (51 males, mean age: 65.8 ± 12.5 years). Prior AP use was associated with a higher rate of early MCA recanalization (53.6 vs. 29.5% in AP naïve, p = 0.007) and was shown as a predictor of ER (OR: 2.30, 95% CI: 1.14-4.65; p = 0.020) in unadjusted analysis. No difference was found in the occurrence of SICH.
  
  
  CONCLUSIONS
  Prior use of AP was associated with a higher rate of ER of occluded MCA, but with no increase of SICH after IVT.
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, Palacký University Medical School, Olomouc, Czech Republic. daniel.sanak@centrum.cz
authors.forename: Daniel
authors.initials: D
authors.lastname: Saňák
authors.forename: Martin
authors.initials: M
authors.lastname: Kuliha
authors.forename: Roman
authors.initials: R
authors.lastname: Herzig
authors.forename: Martin
authors.initials: M
authors.lastname: Roubec
authors.forename: David
authors.initials: D
authors.lastname: Skoloudík
authors.forename: Jana
authors.initials: J
authors.lastname: Zapletalová
authors.forename: Martin
authors.initials: M
authors.lastname: Köcher
authors.forename: Michal
authors.initials: M
authors.lastname: Král
authors.forename: Tomáš
authors.initials: T
authors.lastname: Veverka
authors.forename: Eva
authors.initials: E
authors.lastname: Cecháková
authors.forename: Andrea
authors.initials: A
authors.lastname: Bártková
authors.forename: Václav
authors.initials: V
authors.lastname: Procházka
authors.forename: Petr
authors.initials: P
authors.lastname: Kaňovský
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D010959:Tissue Plasminogen Activator