Effect of alteplase on the CT hyperdense artery sign and outcome after ischemic stroke
نویسندگان
- Grant Mair
- Rüdiger von Kummer
- Zoe Morris
- Anders von Heijne
- Nick Bradey
- Lesley Cala
- André Peeters
- Andrew J. Farrall
- Alessandro Adami
- Gillian Potter
- Geoff Cohen
- Peter A.G. Sandercock
- Richard I. Lindley
- Joanna M. Wardlaw
- Peter Sandercock
- Richard I Lindley
- Joanna M Wardlaw
- Colin Baigent
- David Chadwick
- Pippa Tyrrell
- Gordon Lowe
- Martin Dennis
- Karen Innes
- Heather Goodare
- Graeme J Hankey
- Karl Matz
- Michael Brainin
- Gord Gubitz
- Stephen J Phillips
- Stefano Ricci
- Antonio Arauz
- Eivind Berge
- Karsten Bruins Slot
- Anna Czlonkowska
- Adam Kobayashi
- Manuel Correia
- Phillippe Lyrer
- Stefan Engelter
- Veronica Murray
- Andreas Terent
- Bo Norrving
- Per Wester
- Graham Venables
- Andrew Farrall
- Andre Peeters
- Robin Sellar
- Philip White
- Andrew Demchuk
- Matthew Adams
- Bernard Yan
- G Venables
- C Blank
- H Bowler
- C Doyle
- K Endean
- K Harkness
- E Parker
- M Randall
- C Roffe
- N Ahmad
- A Arora
- S Brammer
- J Chembala
- B Davies
- S Ellis
- E Epstein
- K Finney
- C Jackson
- C Jadun
- R Kinston
- H Maguire
- I Memon
- I Natarajan
- M Poulson
- R Sanyal
- S Sills
- A Vreeburg
- E Ward
- P Sandercock
- R Al-Shahi Salman
- R Davenport
- M Dennis
- P Hand
- S Hart
- I Kane
- S Keir
- M MacLeod
- L McKinlay
- H Milligan
- E Sandeman
- J Stone
- C Sudlow
- P Taylor
- J Wardlaw
- C Warlow
- W Whiteley
- A Williams
- M Brown
- B Athwal
- V Bassan
- N Bhupathiraju
- J Bowler
- C Davie
- D Doig
- R Erande
- S Gilbert
- L Ginsberg
- R Greenwood
- S Gregoire
- N Harding
- N Losseff
- R Luder
- N Passeron
- R Perry
- P Rayson
- R Simister
- S Stone
- D Werring
- J Barrett
- H Aitken
- S Cherian
- R Davis
- S Downham
- L Godd
- V Gott
- D Jose
- V Little
- D Lowe
- L Luxford
- M McGrory
- P Owings
- N Price
- J Richards
- G Sangster
- J Sherlock
- S Vargese
- I Wakefield
- P Weir
- P Guyler
- T Attygale
- S Chandler
- L Coward
- S Feasey
- C Khuoge
- T Loganathan
- S Martin
- A O'Brien
- D Sinha
- V Thompson
- S Tysoe
- R Walsh
- K Metcalf
- J Cochius
- R Fulcher
- N Gange
- C Green
- J Jagger
- M Lee
- P Myint
- J Potter
- G Ravenhill
- S Shields
- N Shinh
- T Staunton
- E Thomas
- W Woodward
- P Worth
- N Wyatt
- W Sunman
- P Bath
- P Berman
- J Clarke
- C Gaynor
- F Hammonds
- R Harwood
- K Mitchell
- S Munshi
- S Pacey
- A Shetty
- N Sprigg
- H Stear
- G Subramanian
- A Wills
- A Rudd
- H Audebert
- A Bhalla
- J Birns
- R Chowdhury
- G Cluckie
- I Davies
- C Gibbs
- P Holmes
- N Mitchell
- F Schiavone
- E White
- M Yeung
- A Mehrzad
- V Baliga
- E Brown
- L Burnside
- B Esisi
- J Kent
- P Orr
- D Stead
- E Wayman
- R Durairaj
- C Cullen
- R Kumar
- H Martin
- D McDowell
- A Sharma
- V Sutton
- R White
- T Hughes
- K Ali
- J Anderson
- K Baker
- K Bethune
- M Booth
- M Cossburn
- S Halpin
- M Hourihan
- E Marsh
- K Peall
- R Powell
- H Shetty
- M Wardle
- M Williams
- K Muhiddin
- J Beavan
- M Clarke
- R Donneley
- S Elliott
- P Fox
- P Gorman
- M Harper
- M Mangoyana
- L Mills
- L Wright
- L Warburton
- J Baron
- P Barry
- D Day
- T Harold
- P Martin
- J Mitchell
- E O'Brien
- J Rycarte
- M Turnham
- G Cloud
- L Choy
- B Clarke
- C Griffin
- O Halse
- I Jones
- F Kennedy
- U Khan
- R Lewis
- A Loosemore
- C Lovelock
- H Markus
- B Moynihan
- J O'Reilly
- O Paul
- A Pereira
- M Punter
- P Rich
- D Rolfe
- M James
- J Bell
- A Bowring
- L Boxall
- J Cageao
- H Eastwood
- S Elyas
- F Hall
- S Harries
- A Hemsley
- S Jackson
- S Keenan
- P Mudd
- A Sekhar
- D Strain
- J Sword
- N Wedge
- M Bruce
- A Joyson
- M Kemp
- K McMullan
- J Reid
- O Robb
- J Webster
- S Wilkinson
- P Sharma
- P Bentley
- H Jenkins
- A Kar
- T Sachs
- D Cohen
- R Bathula
- J Devine
- M Mpelembue
- D Hargroves
- I Balogun
- L Cowie
- A Maidment
- D Rand
- J Rowe
- H Rudenko
- D Smithard
- L Wray
- J Paterson
- J Brown
- J Hampton
- S Jamieson
- R Rose
- A Volans
- K Chatterjee
- G Abbott
- R Brookes
- C Castle
- C Kelly
- S Leason
- A Nallasivan
- A Sen
- D Collas
- M Cottle
- N Damani
- P Jacob
- D Oza
- A Kenton
- N Adab
- L Aldridge
- H Allroggen
- Y Brown
- R Cross
- L Galvin
- K Ghosh
- A Grubneac
- A Lindahl
- H Mehta
- M Pritchard
- C Randall
- P Ray
- A Shehu
- S Thelwell
- D Jenkinson
- T Black
- O David
- J Kwan
- A Orpen
- C Ovington
- D Tiwari
- Z ud Din Babar
- A Hassan
- A Bailey
- J Bamford
- C Bedford
- R Bellfield
- J Cooper
- L Dunsmure
- J Greig
- M Keeling
- L Mandizvidza
- J Rankine
- E Roberts
- P Wanklyn
- T Webb
- S Williamson
- J Coyle
- S Crane
- C Croser
- P Duffey
- R Evans
- E Iveson
- G Kitching
- M Porte
- C Rhymes
- D Barer
- M Armstrong
- M Bokhari
- T Cassidy
- B McClelland
- G Gunathilagan
- P Dolke
- S Jain
- S Jones
- L Rosser
- G Thomas
- C White
- P Sanmuganathan
- C Scholtz
- E Stratford
- M O'Donnell
- H Goddard
- G Hoadley
- J Howard
- S Leach
- J McIlmoyle
- A Stewart
- A Strain
- F Huwez
- P Croot
- N Gadi
- N Mguni
- U Umasankar
- G Mead
- B Chapman
- A Coull
- A Kinnear
- B Morrow
- F Morrow
- D Ames
- J Ball
- S Bannerjee
- J Chataway
- K Rashed
- C Buckley
- D Donaldson
- D Hayward
- C Lawson
- L Sekaran
- K Bharaj
- F Justin
- G Jutlla
- D Phiri
- S Sethuraman
- M Tate
- D Sandler
- P Carr
- G Jones
- J Lyons
- K Warren
- L Kalra
- A Davis
- J Jarosz
- D Manawadu
- L Sztriha
- D Chadha
- A Holford
- P Willcoxson
- L Shaw
- D Button
- A Cunningham
- L Dow
- J Dutson
- T Hall
- C Hardy
- N Jakeman
- P Kaye
- B Madigan
- K O'Brien
- D Pressdee
- M Price
- L Robinson
- C Taylor
- D Williamson
- J McCormack
- C Stretton
- P Earnshaw
- S Bruce
- C Church
- S Desai
- M Myint
- N Watt
- C Price
- H Graham
- R Lakey
- K Mitchelson
- P Murphy
- L Ball
- S Caine
- J Dovey
- J Hughes
- A Steele
- K Dizayee
- A Brown
- T Chattopadhyay
- J Cheetham
- H Cochrane
- A Datta
- M Datta-chaudhuri
- C Fox
- D Kilroy
- S Krishnamoorthy
- F Levy
- S Metha
- P Ngoma
- B Venkatesh
- R Gautam
- N Henderson
- M Jones
- S Murphy
- G Spurling
- I Wiggam
- C Boyd
- K Fullerton
- P Gray
- M Kinnaird
- S MacNair
چکیده
OBJECTIVE To investigate whether the location and extent of the CT hyperdense artery sign (HAS) at presentation affects response to IV alteplase in the randomized controlled Third International Stroke Trial (IST-3). METHODS All prerandomization and follow-up (24-48 hours) CT brain scans in IST-3 were assessed for HAS presence, location, and extent by masked raters. We assessed whether HAS grew, persisted, shrank, or disappeared at follow-up, the association with 6-month functional outcome, and effect of alteplase. IST-3 is registered (ISRCTN25765518). RESULTS HAS presence (vs absence) independently predicted poor 6-month outcome (increased Oxford Handicap Scale [OHS]) on adjusted ordinal regression analysis (odds ratio [OR] 0.66, p < 0.001). Outcome was worse in patients with more (vs less) extensive HAS (OR 0.61, p = 0.027) but not in proximal (vs distal) HAS (p = 0.420). Increasing age was associated with more HAS growth at follow-up (OR 1.01, p = 0.013). Treatment with alteplase increased HAS shrinkage/disappearance at follow-up (OR 0.77, p = 0.006). There was no significant difference in HAS shrinkage with alteplase in proximal (vs distal) or more (vs less) extensive HAS (p = 0.516 and p = 0.580, respectively). There was no interaction between presence vs absence of HAS and benefit of alteplase on 6-month OHS (p = 0.167). CONCLUSIONS IV alteplase promotes measurable reduction in HAS regardless of HAS location or extent. Alteplase increased independence at 6 months in patients with and without HAS. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that for patients within 6 hours of ischemic stroke with a CT hyperdense artery sign, IV alteplase reduced intra-arterial hyperdense thrombus.
منابع مشابه
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عنوان ژورنال:
دوره 86 شماره
صفحات -
تاریخ انتشار 2016