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  4. Vol 5, Issue 5, 2024

Efficacy and Safety of Alteplase in the Acute Ischemic Stroke Patients with Different NIHSS-time Scores

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DOI: 10.23977/medsc.2024.050516 | Downloads: 7 | Views: 205

Author(s)

Yan Wang 1, Kun Liu 2, Li Xu 1

Affiliation(s)

1 Emergency and Disaster Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
2 Cerebrovascular Neurosurgery Department, The Second People's Hospital of Hunan Province, Changsha, China

Corresponding Author

Kun Liu

ABSTRACT

This study investigates the efficacy and safety of alteplase in acute ischemic stroke (AIS) patients with different NIHSS-time scores. 208 AIS patients admitted to the second people's hospital from 1 March 2019 to 31 May 2022 who received standard doses of intravenous thrombolysis of alteplase (rt-PA) were divided into the NIHSS-time ≤20 group (n=142), the NIHSS-time 20-40 group (n=49) and the NIHSS-time >40 group (n=17). The early neurological improvement (ENI) scores 24 h after thrombolysis, the ENI scores 7 d after thrombolysis, and the modified Rankin scale (mRS) score 90 days after onset were statistically significant among the three groups (P< 0.05). Compared with the NIHSS-time ≤20 group, both the P values of sICH within 7 days after thrombolysis and systemic bleeding within 7 days after thrombolysis are >0.05 in the NIHSS-time 20-40 group, and the differences are not statistically significant. Compared with the NIHSS-time ≤20 group, all the P values of sICH within 7 days after thrombolysis, systemic bleeding within 7 days after thrombolysis, and all-cause death within 90 days after thrombolysis are <0.05 in the NIHSS-time >40 group, and the differences are statistically significant. Compared with the NIHSS-time 20-40 group, the P value for the occurrence of both the sICH within 7 days after thrombolysis and all-cause death within 90 days after thrombolysis are <0.05, and the differences are statistically significant, while the P value for systemic bleeding within 7 days after thrombolysis is >0.05, and the difference is not statistically significant. This single-center retrospective study indicates that NIHSS-time score can predict the efficacy and safety of standard-dose rt-PA intravenous thrombolysis in patients with AIS. It needs to be further confirmed by a large-sample multicenter randomized controlled test.

KEYWORDS

Acute ischemic stroke, NIHSS, intravenous thrombolysis, alteplase, efficacy, safety

CITE THIS PAPER

Yan Wang, Kun Liu, Li Xu. Efficacy and Safety of Alteplase in the Acute Ischemic Stroke Patients with Different NIHSS-time Scores. MEDS Clinical Medicine (2024) Vol. 5: 111-118. DOI: http://dx.doi.org/10.23977/medsc.2024.050516.

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