title: Effect of Cardioembolic Etiology on Intravenous Thrombolysis Efficacy for Acute Ischemic Stroke.
abstract: Previous clinical studies suggest that intravenous (IV) recombinant tissue plasminogen activator (rt-PA) benefits stroke patients regardless of the underlying etiology. In this study, we assessed the possible differences in response to IV rt-PA between cardioembolic stroke and other stroke subtypes. A total of 303 consecutive stroke ischemic patients (from January 2005 to April 2014) admitted to our Stroke Unit and treated with IV rt-PA were retrospectively reviewed. All patients were classified in two groups: Cardioembolic (CE) and Non-Cardioembolic (NCE). We analyzed a total of 303 patients. Thirty patients died in the first hours after fibrinolysis and no statistically significant differences were found in two groups (14 CE vs 18 N-CE). We observed a significant differences in clinical outcome in terms of symptoms "improvement" (p< 0.01 .2) and symptoms" regression" (p<0.057 .2) even if this last result did not reach statistical significance in CE patients respect to N-CE patients. In conclusion, the intravenous fibrinolysis is more effective in CE group than in N-CE regarding symptoms "improvement" and the PFO-Stroke patients treated with fibrinolysis have better outcome than other patients and they have high rate of symptoms" regression". Moreover the main predictor of good outcomes were younger age and milder stroke severity on hospital admission.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Anticoli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Bravi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Perillo
authors.affiliation: Department of Neurology, Annunziata Hospital, Via F. Migliori, 1, 87100- Cosenza, Italy. anto.siniscalchi@libero.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Siniscalchi
authors.forename: Claudio
authors.initials: C
authors.lastname: Pozzessere
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Pezzella
authors.forename: Piero
authors.initials: P
authors.lastname: Tanzi
authors.forename: Luca
authors.initials: L
authors.lastname: Gallelli
authors.forename: Domenico
authors.initials: D
authors.lastname: Cartoni
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology* / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator