title: Effects of edaravone on early outcomes in acute ischemic stroke patients treated with recombinant tissue plasminogen activator.
abstract: BACKGROUND
  We investigated whether edaravone could improve early outcomes in acute ischemic stroke patients treated with recombinant tissue plasminogen activator (rtPA).
  
  
  METHODS
  We conducted a retrospective cohort study using the Japanese Diagnosis Procedure Combination database. We identified patients admitted with a primary diagnosis of ischemic stroke from 1 July 2010 to 31 March 2012 and treated with rtPA on the same day of stroke onset or the following day. Thereafter, we selected those who received edaravone on the same day of rtPA administration (edaravone group), and those who received rtPA without edaravone (control group). The primary outcomes were modified Rankin Scale (mRS) scores at discharge. One-to-one propensity-score matching was performed between the edaravone and control groups. An ordinal logistic regression analysis for mRS scores at discharge was performed with adjustment for possible variables as well as clustering of patients within hospitals using a generalized estimating equation.
  
  
  RESULTS
  We identified 6336 eligible patients for inclusion in the edaravone group (n=5979; 94%) and the control group (n=357; 6%) as the total population. In 356 pairs of the propensity-matched population, the ordinal logistic regression analysis showed that edaravone was significantly associated with lower mRS scores of patients at discharge (adjusted odds ratio: 0.74; 95% confidence interval: 0.57-0.96).
  
  
  CONCLUSIONS
  Edaravone may improve early outcomes in acute ischemic stroke patients treated with rtPA.
authors.affiliation: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: wadat-eme@h.u-tokyo.ac.jp.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Wada
authors.affiliation: Department of Clinical Epidemiology and Health Economics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: yasunagah-tky@umin.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.affiliation: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: inokuchir-icu@h.u-tokyo.ac.jp.
authors.forename: Ryota
authors.initials: R
authors.lastname: Inokuchi
authors.affiliation: Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, 2-5-21 Higashigaoka, Meguro-ku, Tokyo 152-8621, Japan. Electronic address: hiromasa-horiguchi@nho.hosp.go.jp.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.affiliation: Department of Health Care Informatics, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.affiliation: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: matsubarat-ort@h.u-tokyo.ac.jp.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: nakajimas-ort@h.u-tokyo.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakajima
authors.affiliation: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: yahagin-eme@h.u-tokyo.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000983:Antipyrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016208:Databases, Factual / Q000706:statistics & numerical data; D000077553:Edaravone; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D016166:Free Radical Scavengers; D010959:Tissue Plasminogen Activator; D000077553:Edaravone; D000983:Antipyrine
keywords: Acute ischemic stroke; Cohort study; Edaravone; Neuroprotection; Propensity-score matching; The Diagnosis Procedure Combination database; Thrombolysis