Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke

Background: Current guidelines recommend withholding antithrombotic therapy (ATT) for at least 24 h in patients with acute ischemic stroke treated with thrombolytic therapy. Herein, we report a retrospective analysis of a single-centre experience on the safety and efficacy of antithrombotic therapy...

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Autores: Amaro Delgado, Sergio, Llull Estrany, Laura, Urra, Xabier, Obach, Víctor, Cervera Álvarez, Álvaro, Chamorro Sánchez, Ángel
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2013
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/148917
Acesso em linha:https://hdl.handle.net/2445/148917
Access Level:acceso abierto
Palavra-chave:Isquèmia cerebral
Heparina
Malalties cerebrovasculars
Cerebral ischemia
Heparin
Cerebrovascular disease
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spelling Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute StrokeAmaro Delgado, SergioLlull Estrany, LauraUrra, XabierObach, VíctorCervera Álvarez, ÁlvaroChamorro Sánchez, ÁngelIsquèmia cerebralHeparinaMalalties cerebrovascularsCerebral ischemiaHeparinCerebrovascular diseaseBackground: Current guidelines recommend withholding antithrombotic therapy (ATT) for at least 24 h in patients with acute ischemic stroke treated with thrombolytic therapy. Herein, we report a retrospective analysis of a single-centre experience on the safety and efficacy of antithrombotic therapy (ATT) started before or after 24 h of intravenous thrombolysis in a cohort of acute ischemic stroke patients. Methods: A total of 139 patients (Rapid ATT group) received antithrombotic therapy before 24 h of thrombolysis, and 33 patients (Standard ATT group) after 24 h. The brain parenchyma and vessel status were assessed using simple CT scan on admission, multimodal CT scan at the end of thrombolysis, and angio-CT/MRI scan at day 3. Functional outcome was scored using the modified Rankin Scale (mRS) at day 90. Results: The two ATT groups had similar demographics, stroke subtypes, baseline NIHSS, thrombolytic strategies, vesselpatency rates at the end of thrombolysis, and incidence of bleeding complications at follow up. At day 3, the Rapid ATT group had a non-significant improved vessel-patency rate than the Standard ATT group. At day 90, a greater proportion of patients in the rapid ATT group had shifted down the mRS, and had improved in the NIHSS score. Conclusions: ATT initiated before 24 h of intravenous thrombolytic therapy in acute stroke patients disclosed no safety concerns compared with a conventional antithrombotic therapy delay of 24 h and showed better functional outcome at follow up. The value of early initiation of ATT after thrombolysis deserves further assessment in randomized controlled trialsPublic Library of Science (PLoS)2020202020132020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion6 p.application/pdfhttps://hdl.handle.net/2445/148917Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0071132PLoS One, 2013, vol. 8, num. 8, p. e71132https://doi.org/10.1371/journal.pone.0071132cc-by (c) Amaro, Sergio et al., 2013http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1489172026-05-29T05:05:01Z
dc.title.none.fl_str_mv Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
title Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
spellingShingle Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
Amaro Delgado, Sergio
Isquèmia cerebral
Heparina
Malalties cerebrovasculars
Cerebral ischemia
Heparin
Cerebrovascular disease
title_short Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
title_full Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
title_fullStr Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
title_full_unstemmed Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
title_sort Risks and Benefits of Early Antithrombotic Therapy after Thrombolytic Treatment in Patients with Acute Stroke
dc.creator.none.fl_str_mv Amaro Delgado, Sergio
Llull Estrany, Laura
Urra, Xabier
Obach, Víctor
Cervera Álvarez, Álvaro
Chamorro Sánchez, Ángel
author Amaro Delgado, Sergio
author_facet Amaro Delgado, Sergio
Llull Estrany, Laura
Urra, Xabier
Obach, Víctor
Cervera Álvarez, Álvaro
Chamorro Sánchez, Ángel
author_role author
author2 Llull Estrany, Laura
Urra, Xabier
Obach, Víctor
Cervera Álvarez, Álvaro
Chamorro Sánchez, Ángel
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Isquèmia cerebral
Heparina
Malalties cerebrovasculars
Cerebral ischemia
Heparin
Cerebrovascular disease
topic Isquèmia cerebral
Heparina
Malalties cerebrovasculars
Cerebral ischemia
Heparin
Cerebrovascular disease
description Background: Current guidelines recommend withholding antithrombotic therapy (ATT) for at least 24 h in patients with acute ischemic stroke treated with thrombolytic therapy. Herein, we report a retrospective analysis of a single-centre experience on the safety and efficacy of antithrombotic therapy (ATT) started before or after 24 h of intravenous thrombolysis in a cohort of acute ischemic stroke patients. Methods: A total of 139 patients (Rapid ATT group) received antithrombotic therapy before 24 h of thrombolysis, and 33 patients (Standard ATT group) after 24 h. The brain parenchyma and vessel status were assessed using simple CT scan on admission, multimodal CT scan at the end of thrombolysis, and angio-CT/MRI scan at day 3. Functional outcome was scored using the modified Rankin Scale (mRS) at day 90. Results: The two ATT groups had similar demographics, stroke subtypes, baseline NIHSS, thrombolytic strategies, vesselpatency rates at the end of thrombolysis, and incidence of bleeding complications at follow up. At day 3, the Rapid ATT group had a non-significant improved vessel-patency rate than the Standard ATT group. At day 90, a greater proportion of patients in the rapid ATT group had shifted down the mRS, and had improved in the NIHSS score. Conclusions: ATT initiated before 24 h of intravenous thrombolytic therapy in acute stroke patients disclosed no safety concerns compared with a conventional antithrombotic therapy delay of 24 h and showed better functional outcome at follow up. The value of early initiation of ATT after thrombolysis deserves further assessment in randomized controlled trials
publishDate 2013
dc.date.none.fl_str_mv 2013
2020
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/148917
url https://hdl.handle.net/2445/148917
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0071132
PLoS One, 2013, vol. 8, num. 8, p. e71132
https://doi.org/10.1371/journal.pone.0071132
dc.rights.none.fl_str_mv cc-by (c) Amaro, Sergio et al., 2013
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Amaro, Sergio et al., 2013
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 6 p.
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,228081

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