title: Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation.
abstract: The outcome of early intravenous thrombolysis for ischemic stroke in patients with atrial fibrillation (AF) is worse than that without thrombosis. How to increase the efficacy of intravenous thrombolysis for AF-related ischemic stroke remains largely unknown. In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P < 0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P = 0.045); high systolic pressure (P = 0.039); high blood glucose (P = 0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001). Moreover, high systolic pressure at admission (P = 0.007), high blood glucose (P = 0.027), and a high NIHSS score (P < 0.001) were independent risk factors for mortality at 3 months. Besides thrombolysis, a high NIHSS score (P = 0.006) and warfarin taken within 48 h before stroke onset (P = 0.032) were also independent risk factors for symptomatic hemorrhage within 24 h after treatment. Ischemic stroke patients with AF benefited from intravenous thrombolysis with recombinant tissue plasminogen activator within 4.5 h after stroke.
authors.affiliation: Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China.|Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.|Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, 210008, China.
authors.forename: Qiuyun
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, Northern Jiangsu People's Hospital, Yangzhou, 225001, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Li
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
authors.forename: Wanli
authors.initials: W
authors.lastname: Dong
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, 210019, China.
authors.forename: Min
authors.initials: M
authors.lastname: Ye
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China.|Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, 210008, China.
authors.forename: Meijuan
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The Affiliated Huaian First People's Hospital of Nanjing Medical University, Huaian, 223300, China.
authors.forename: Qiantao
authors.initials: Q
authors.lastname: Cheng
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
authors.forename: Junshan
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, Affiliated Xuzhou Central Hospital of Xuzhou Medical College, Xuzhou, 221009, China.
authors.forename: Guofang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, 212002, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Yu
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, Jiangyin People's Hospital, Jiangyin, 214400, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Hong
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221006, China.
authors.forename: Xiue
authors.initials: X
authors.lastname: Wei
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The First People's Hospital of Lianyungang, Lianyungang, 222002, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The First Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221000, China.
authors.forename: Guiyun
authors.initials: G
authors.lastname: Cui
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ding
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China.|Department of Neurology, Gaochun People's Hospital, Nanjing, 211300, China.
authors.forename: Rongzhen
authors.initials: R
authors.lastname: Xu
authors.affiliation: Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China. chenyan20141014@163.com.|Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, 210008, China. chenyan20141014@163.com.|Department of Neurology, Drum Tower Hospital of Nanjing Medical University, Nanjing, 210008, China. chenyan20141014@163.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China. xuyun20042001@aliyun.com.|Jiangsu Stroke Research Collaborative Group, Nanjing, 210008, China. xuyun20042001@aliyun.com.|Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, 210008, China. xuyun20042001@aliyun.com.|Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, 210008, China. xuyun20042001@aliyun.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Atrial fibrillation; Favorable outcome; Intravenous recombinant tissue plasminogen activator; Intravenous thrombolysis; Ischemic stroke; Risk factors