Intravenous thrombolysis in ischemic stroke patients with a prior intracranial hemorrhage: a meta-analysis.
intracranial hemorrhages
intravenous thrombolytic therapy
ischemic stroke
mortality
symptomatic hemorrhagic transformation
Journal
Therapeutic advances in neurological disorders
ISSN: 1756-2856
Titre abrégé: Ther Adv Neurol Disord
Pays: England
ID NLM: 101480242
Informations de publication
Date de publication:
2022
2022
Historique:
received:
18
11
2021
accepted:
01
01
2022
entrez:
7
2
2022
pubmed:
8
2
2022
medline:
8
2
2022
Statut:
epublish
Résumé
The history of intracranial hemorrhage (ICrH) is considered a contraindication for intravenous thrombolysis (IVT) among patients with acute ischemic stroke (AIS). Objective: This study aimed at comparing the safety of IVT among patients with and without a history of ICrH. We performed a systematic review of the literature. Data regarding all AIS patients with prior ICrH who received IVT were retrieved. Meta-analysis was performed to compare the rate of symptomatic hemorrhagic transformation (sHT), death within 90 days, and favorable and unfavorable 90-day functional outcomes based on modified Rankin Scale (mRS) among stroke patients with and without prior ICrH. Out of 13,032 reviewed records, 7 studies were included in the systematic review and meta-analysis. Quantitative synthesis of data regarding the rate of sHT (5068 patients) revealed no significant difference between the two groups [odds ratio, OR: 1.55 (0.77, 3.12); The results of this study indicated that prior history of ICrH does not increase the risk of sHT post-IVT, but it is associated with a higher risk of death and poor functional outcomes in 90 days.
Sections du résumé
BACKGROUND
BACKGROUND
The history of intracranial hemorrhage (ICrH) is considered a contraindication for intravenous thrombolysis (IVT) among patients with acute ischemic stroke (AIS). Objective: This study aimed at comparing the safety of IVT among patients with and without a history of ICrH.
METHODS
METHODS
We performed a systematic review of the literature. Data regarding all AIS patients with prior ICrH who received IVT were retrieved. Meta-analysis was performed to compare the rate of symptomatic hemorrhagic transformation (sHT), death within 90 days, and favorable and unfavorable 90-day functional outcomes based on modified Rankin Scale (mRS) among stroke patients with and without prior ICrH.
RESULTS
RESULTS
Out of 13,032 reviewed records, 7 studies were included in the systematic review and meta-analysis. Quantitative synthesis of data regarding the rate of sHT (5068 patients) revealed no significant difference between the two groups [odds ratio, OR: 1.55 (0.77, 3.12);
CONCLUSION
CONCLUSIONS
The results of this study indicated that prior history of ICrH does not increase the risk of sHT post-IVT, but it is associated with a higher risk of death and poor functional outcomes in 90 days.
Identifiants
pubmed: 35126671
doi: 10.1177/17562864221074144
pii: 10.1177_17562864221074144
pmc: PMC8808019
doi:
Types de publication
Journal Article
Langues
eng
Pagination
17562864221074144Informations de copyright
© The Author(s), 2022.
Déclaration de conflit d'intérêts
Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
JAMA Neurol. 2016 Jun 1;73(6):675-83
pubmed: 27088650
Stroke. 2009 Jul;40(7):2382-6
pubmed: 19443797
Stroke. 2014 Apr;45(4):1000-6
pubmed: 24603072
Eur J Epidemiol. 2010 Sep;25(9):603-5
pubmed: 20652370
Neurol Sci. 2019 Jun;40(6):1157-1166
pubmed: 30830567
Cerebrovasc Dis. 2015;40(5-6):201-4
pubmed: 26402147
Stroke. 2016 Feb;47(2):581-641
pubmed: 26696642
Stroke. 2017 Aug;48(8):2084-2090
pubmed: 28720659
Cerebrovasc Dis. 2014;38(2):107-16
pubmed: 25277866
J Stroke Cerebrovasc Dis. 2018 Mar;27(3):620-624
pubmed: 29100859
Eur Stroke J. 2021 Mar;6(1):I-LXII
pubmed: 33817340
J Neurol Neurosurg Psychiatry. 2008 Oct;79(10):1093-9
pubmed: 18223014
Ther Adv Neurol Disord. 2021 Feb 26;14:1756286421997368
pubmed: 33737956
Cerebrovasc Dis. 2014;37(1):5-13
pubmed: 24355873
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
PLoS Med. 2009 Jul 21;6(7):e1000100
pubmed: 19621070
Stroke. 2010 Jul;41(7):1450-8
pubmed: 20538701
Cochrane Database Syst Rev. 2014 Jul 29;(7):CD000213
pubmed: 25072528
J Neurol. 2017 Jul;264(7):1309-1319
pubmed: 27885484
J Neurol. 2020 Feb;267(2):301-307
pubmed: 30542950
JAMA Neurol. 2017 Nov 1;74(11):1328-1335
pubmed: 28973174
J Clin Neurosci. 2010 Aug;17(8):988-92
pubmed: 20510615
Acta Neurol Scand. 2013 Jul;128(1):48-53
pubmed: 23311439
Neurohospitalist. 2015 Jul;5(3):110-21
pubmed: 26288669
Stroke. 2020 Aug;51(8):2322-2331
pubmed: 32611284
J Thromb Haemost. 2012 Jul;10(7):1270-5
pubmed: 22541172
Braz J Med Biol Res. 2019 Jan 24;52(2):e7739
pubmed: 30698226
Cerebrovasc Dis. 2012;34(2):106-14
pubmed: 22868870
Stroke. 2017 Jul;48(7):1720-1722
pubmed: 28619988
Stroke. 2020 Feb;51(2):533-541
pubmed: 31884908
J Neurol Neurosurg Psychiatry. 2019 Dec;90(12):1383-1385
pubmed: 30995998
J Neurol Sci. 2019 Apr 15;399:76-81
pubmed: 30780072
J Gen Intern Med. 2018 Aug;33(8):1260-1267
pubmed: 29663281
Yonsei Med J. 2019 Aug;60(8):774-781
pubmed: 31347333
Eur J Neurol. 2010 Sep;17(9):1188-1192
pubmed: 20236303
Stroke. 2018 Mar;49(3):e46-e110
pubmed: 29367334
Ann Indian Acad Neurol. 2019 Jul-Sep;22(3):336-340
pubmed: 31359953
Eur Stroke J. 2019 Mar;4(1):13-28
pubmed: 31165091
Int J Stroke. 2016 Oct;11(7):783-90
pubmed: 27312681
J Clin Epidemiol. 2000 Nov;53(11):1119-29
pubmed: 11106885
Stroke. 2014 Aug;45(8):2354-8
pubmed: 25013020
N Engl J Med. 2016 Jun 16;374(24):2313-23
pubmed: 27161018
N Engl J Med. 2008 Sep 25;359(13):1317-29
pubmed: 18815396
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120