Quality of Life After Intravenous Thrombolysis for Acute Ischemic Stroke: Results From the AcT Randomized Controlled Trial.

quality of life randomized controlled trial stroke

Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
26 Jan 2024
Historique:
medline: 26 1 2024
pubmed: 26 1 2024
entrez: 26 1 2024
Statut: aheadofprint

Résumé

Recent evidence from thrombolysis trials indicates the noninferiority of intravenous tenecteplase to intravenous alteplase with respect to good functional outcomes in patients with acute stroke. We examined whether the health-related quality of life (HRQOL) of patients with acute stroke differs by the type of thrombolysis treatment received. In addition, we examined the association between the modified Rankin Scale score 0 to 1 and HRQOL and patient-reported return to prebaseline stroke functioning at 90 days. Data were from all patients included in the AcT trial (Alteplase Compared to Tenecteplase), a pragmatic, registry-linked randomized trial comparing tenecteplase with alteplase. HRQOL at 90-day post-randomization was assessed using the 5-item EuroQOL questionnaire (EQ5D), which consists of 5 items and a visual analog scale (VAS). EQ5D index values were estimated from the EQ5D items using the time tradeoff approach based on Canadian norms. Tobit regression and quantile regression models were used to evaluate the adjusted effect of tenecteplase versus alteplase treatment on the EQ5D index values and VAS score, respectively. The association between return to prebaseline stroke functioning and the modified Rankin Scale score 0 to 1 and HRQOL was quantified using correlation coefficient ( Of 1577 included in the intention-to-treat analysis patients, 1503 (95.3%) had complete data on the EQ5D. Of this, 769 (51.2%) were administered tenecteplase and 717 (47.7%) were female. The mean EQ5D VAS score and EQ5D index values were not significantly higher for those who received intravenous tenecteplase compared with those who received intravenous alteplase ( Although there is no differential effect of thrombolysis type on patient-reported global HRQOL and EQ 5D-5L index values in patients with acute stroke, sex- and age-related differences in HRQOL were noted in this study. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03889249.

Sections du résumé

BACKGROUND UNASSIGNED
Recent evidence from thrombolysis trials indicates the noninferiority of intravenous tenecteplase to intravenous alteplase with respect to good functional outcomes in patients with acute stroke. We examined whether the health-related quality of life (HRQOL) of patients with acute stroke differs by the type of thrombolysis treatment received. In addition, we examined the association between the modified Rankin Scale score 0 to 1 and HRQOL and patient-reported return to prebaseline stroke functioning at 90 days.
METHODS UNASSIGNED
Data were from all patients included in the AcT trial (Alteplase Compared to Tenecteplase), a pragmatic, registry-linked randomized trial comparing tenecteplase with alteplase. HRQOL at 90-day post-randomization was assessed using the 5-item EuroQOL questionnaire (EQ5D), which consists of 5 items and a visual analog scale (VAS). EQ5D index values were estimated from the EQ5D items using the time tradeoff approach based on Canadian norms. Tobit regression and quantile regression models were used to evaluate the adjusted effect of tenecteplase versus alteplase treatment on the EQ5D index values and VAS score, respectively. The association between return to prebaseline stroke functioning and the modified Rankin Scale score 0 to 1 and HRQOL was quantified using correlation coefficient (
RESULTS UNASSIGNED
Of 1577 included in the intention-to-treat analysis patients, 1503 (95.3%) had complete data on the EQ5D. Of this, 769 (51.2%) were administered tenecteplase and 717 (47.7%) were female. The mean EQ5D VAS score and EQ5D index values were not significantly higher for those who received intravenous tenecteplase compared with those who received intravenous alteplase (
CONCLUSIONS UNASSIGNED
Although there is no differential effect of thrombolysis type on patient-reported global HRQOL and EQ 5D-5L index values in patients with acute stroke, sex- and age-related differences in HRQOL were noted in this study.
REGISTRATION UNASSIGNED
URL: https://www.clinicaltrials.gov; Unique identifier: NCT03889249.

Identifiants

DOI: 10.1161/STROKEAHA.123.044690 PMID: 38275116
pubmed: 38275116
doi: 10.1161/STROKEAHA.123.044690
doi:

Banques de données

ClinicalTrials.gov
['NCT03889249']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Auteurs

Tolulope T Sajobi (TT)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
ORCID: 0000-0002-5696-5552

Olayinka I Arimoro (OI)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
ORCID: 0009-0009-9464-589X

Ayoola Ademola (A)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
ORCID: 0000-0002-8412-6246

Nishita Singh (N)

Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada (N.S., J.S.S.).
University of Manitoba, Winnipeg, Canada (N.S., J.S.S.).
ORCID: 0000-0003-3647-0904

Fouzi Bala (F)

Department of Diagnostic and Interventional Neuroradiology, Tours University Hospital, France (F. Bala).
ORCID: 0000-0001-6748-2081

Mohammed A Almekhlafi (MA)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
Department of Radiology, Cumming School of Medicine, University of Calgary, AB, Canada. (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
Hotchkiss Brain Institute, Calgary, AB, Canada (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
ORCID: 0000-0001-9550-8197

Yan Deschaintre (Y)

Département of Neurosciences, Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).
Centre Hospitalier de l'Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).

Shelagh B Coutts (SB)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
Department of Radiology, Cumming School of Medicine, University of Calgary, AB, Canada. (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
Hotchkiss Brain Institute, Calgary, AB, Canada (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
ORCID: 0000-0001-5090-5105

Sibi Thirunavukkarasu (S)

Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada (S.T., S.M.M., M.P.K., B.H.B.).
ORCID: 0000-0001-5603-2237

Houman Khosravani (H)

Division of Neurology, Department of Medicine, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada (H.K., D.J.G., R.H.S.).
ORCID: 0000-0002-4059-9420

Ramana Appireddy (R)

Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada (R.A., S.J.).
ORCID: 0000-0003-1831-5804

François Moreau (F)

Université de Sherbrooke, QC, Canada (F.M.).

Gordon J Gubitz (GJ)

Queen Elizabeth Health Sciences Centre, Halifax, NS, Canada (G.J.G., S.J.P., A. Shoamanesh).

Aleksander Tkach (A)

Kelowna General Hospital, BC, Canada (A.T., E.E.).

Luciana Catanese (L)

Hamilton Health Sciences Centre, McMaster University, Hamilton, ON, Canada (L.C.).
ORCID: 0000-0002-8696-5211

Dar Dowlatshahi (D)

Department of Medicine, Ottawa Heart Research Institute, University of Ottawa, ON, Canada (D.D., M. Shamy).
ORCID: 0000-0003-1379-3612

George Medvedev (G)

Department of Medicine, University of British Columbia & Fraser Health Authority, New Westminster, BC, Canada (G.M., G.S.).
University of British Columbia, Fraser Health Authority, New Westminster, BC, Canada (G.M., G.S.).
ORCID: 0000-0002-9941-876X

Jennifer Mandzia (J)

London Health Sciences Centre and Western University, ON, Canada (J.M.).
ORCID: 0000-0002-1331-0695

Aleksandra Pikula (A)

Toronto Western Hospital, University of Toronto, ON, Canada (A.P.).
ORCID: 0000-0001-7077-0148

Jai Shiva Shankar (JS)

Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada (N.S., J.S.S.).
University of Manitoba, Winnipeg, Canada (N.S., J.S.S.).
ORCID: 0000-0002-3707-9723

Heather Williams (H)

Queen Elizabeth Hospital, Charlottetown, PC, Canada (H.W.).

Thalia S Field (TS)

Vancouver Stroke Program, Division of Neurology, The University of British Columbia, Vancouver, Canada (T.S.F.).
ORCID: 0000-0002-1176-0633

Alejandro Manosalva (A)

Medicine Hat Regional Hospital, Medicine Hat, AB, Canada (A.M.).
ORCID: 0000-0001-8801-9248

Muzaffar Siddiqui (M)

Grey Nuns Community Hospital, Edmonton, AB, Canada (M. Siddiqui).

Atif Zafar (A)

St. Michael's Hospital, Toronto, ON, Canada (A.Z.).
ORCID: 0000-0002-2738-5225

Oje Imoukhuede (O)

Red Deer Regional Hospital, Red Deer, AB, Canada (O.I.).

Gary Hunter (G)

University of Saskatchewan, Saskatoon, Canada (G.H.).
ORCID: 0000-0003-2033-8001

Andrew M Demchuk (AM)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
Department of Radiology, Cumming School of Medicine, University of Calgary, AB, Canada. (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
Hotchkiss Brain Institute, Calgary, AB, Canada (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
ORCID: 0000-0002-4930-7789

Sachin M Mishra (SM)

Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada (S.T., S.M.M., M.P.K., B.H.B.).

Laura C Gioia (LC)

Département of Neurosciences, Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).
Centre Hospitalier de l'Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).
ORCID: 0000-0001-7382-4973

Shirin Jalini (S)

Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada (R.A., S.J.).
ORCID: 0009-0007-7548-6702

Caroline Cayer (C)

Centre de recherche du CHUS, Centre intégré Universitaire de Santé et des Services Sociaux de l'Estrie, Sherbrooke, QC, Canada (C.C.).
ORCID: 0000-0002-8722-612X

Stephen J Phillips (SJ)

Queen Elizabeth Health Sciences Centre, Halifax, NS, Canada (G.J.G., S.J.P., A. Shoamanesh).
ORCID: 0000-0002-7880-9358

Elsadig Elamin (E)

Kelowna General Hospital, BC, Canada (A.T., E.E.).

Ashkan Shoamanesh (A)

Queen Elizabeth Health Sciences Centre, Halifax, NS, Canada (G.J.G., S.J.P., A. Shoamanesh).
ORCID: 0000-0002-2802-1626

Suresh Subramaniam (S)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
ORCID: 0009-0005-8010-7960

Mahesh P Kate (MP)

Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada (S.T., S.M.M., M.P.K., B.H.B.).
ORCID: 0000-0003-4794-2882

Gregory Jacquin (G)

Département of Neurosciences, Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).
Centre Hospitalier de l'Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).
ORCID: 0000-0003-4362-1571

Marie-Christine Camden (MC)

Enfant-Jésus Hospital, Centre Hospitalier Universitaire de Québec, Laval University, Canada (M.-C.C.).
ORCID: 0000-0002-7824-0229

Faysal Benali (F)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).

Ibrahim Alhabli (I)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
ORCID: 0000-0002-6293-6934

MacKenzie Horn (M)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
ORCID: 0000-0002-1472-3977

Grant Stotts (G)

Department of Medicine, University of British Columbia & Fraser Health Authority, New Westminster, BC, Canada (G.M., G.S.).
University of British Columbia, Fraser Health Authority, New Westminster, BC, Canada (G.M., G.S.).
ORCID: 0000-0001-8226-4883

Michael D Hill (MD)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
Department of Radiology, Cumming School of Medicine, University of Calgary, AB, Canada. (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
Hotchkiss Brain Institute, Calgary, AB, Canada (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
ORCID: 0000-0002-6269-1543

David J Gladstone (DJ)

Division of Neurology, Department of Medicine, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada (H.K., D.J.G., R.H.S.).

Alexandre Y Poppe (AY)

Département of Neurosciences, Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).
Centre Hospitalier de l'Université de Montréal, QC, Canada (Y.D., L.C.G., G.J., A.Y.P.).
ORCID: 0000-0002-1419-2635

Arshia Sehgal (A)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
ORCID: 0000-0002-9666-7947

Qiao Zhang (Q)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).

Brendan Lethebe (B)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
ORCID: 0000-0001-5867-6132

Craig Doram (C)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).

Michel Shamy (M)

Department of Medicine, Ottawa Heart Research Institute, University of Ottawa, ON, Canada (D.D., M. Shamy).
ORCID: 0000-0002-0085-6816

Carol Kenney (C)

Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).

Brian H Buck (BH)

Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada (S.T., S.M.M., M.P.K., B.H.B.).
ORCID: 0000-0002-7984-6062

Richard H Swartz (RH)

Division of Neurology, Department of Medicine, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada (H.K., D.J.G., R.H.S.).
ORCID: 0000-0001-6571-5531

Bijoy K Menon (BK)

Department of Community Health Sciences, University of Calgary, AB, Canada (T.T.S., O.I.A., A.A., M.A.A., S.B.C., A.M.D., M.D.H., B.L., B.K.M.).
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, AB, Canada. (T.T.S., A.A., M.A.A., S.B.C., A.M.D., S.S., F. Benali, I.A., M.H., M.D.H., A. Sehgal, Q.Z., C.D., C.K., B.K.M.).
Department of Radiology, Cumming School of Medicine, University of Calgary, AB, Canada. (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
Hotchkiss Brain Institute, Calgary, AB, Canada (M.A.A., S.B.C., A.M.D., M.D.H., B.K.M.).
ORCID: 0000-0002-3466-496X

Classifications MeSH