Leukocytes are systematic inflammation indicators related to stroke prognosis and can exhibit large dynamic waves before and after recombinant tissue plasminogen activator (r-tPA) therapy. However, additional evidence is needed to determine the prognostic significance of various leukocytes including both static and dynamic data among patients who underwent r-tPA therapy. A total of 251 patients treated with r-tPA were included; their leukocyte data were collected at two time points, and patients were followed up for three months. Analysis revealed the following findings. (i) Patients with hemorrhagic transformation (HT) and unfavorable outcomes had a higher level of leukocytes after r-tPA therapy (leukocyte count (adjusted OR (aOR) 1.191 for HT and 1.184 for unfavorable outcomes), neutrophil count (aOR 1.215 and 1.214), neutrophil-to-lymphocyte ratio (NLR; aOR 1.084 and 1.091)) and larger dynamic leukocyte changes. (ii)Among all leukocytes, the NLR after r-tPA administration demonstrated the strongest correlation with HT and unfavorable outcomes. (iii) Patients with an NLR ≥ 3.322 had a 3.492-fold increased risk for HT, and those with an NLR ≥ 5.511 had a 3.024-fold increased risk for functional outcomes. Overall, this study shows that leukocytes, especially leukocyte count, neutrophil count and the NLR, are independently associated with HT and functional outcomes in stroke patients.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9941866 | PMC |
| http://dx.doi.org/10.1177/0271678X221142694 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Dual antiplatelet versus alteplase in anterior and posterior circulation minor stroke.
Stroke Vasc Neurol
December 2024
Department of Neurology, General Hospital of Northern Theatre Command, Shenyang, Liaoning, China
Objective: The Antiplatelet versus R-tPA for Acute Mild Ischaemic Stroke trial has demonstrated the non-inferiority of dual antiplatelet therapy (DAPT) to alteplase in minor non-disabling stroke. This prespecified secondary analysis aimed to investigate whether the treatment effects were similar across stroke territories.
Methods: Participants were divided according to stroke territory, which were subdivided into DAPT and alteplase.
Dual Antiplatelet Versus Alteplase for Early Neurologic Deterioration in Minor Stroke With Versus Without Large Vessel Occlusion: Prespecified Post Hoc Analysis of the ARAMIS Trial.
Stroke
November 2024
Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China (Y.C., C.H., Z.-A.L., Y.W., H.-S.C.).
Article Synopsis
- A study analyzed the effectiveness of dual antiplatelet therapy (DAPT) compared to alteplase for treating minor strokes without large vessel occlusion, finding that DAPT was associated with less early neurological deterioration (END).
- Among 480 patients, DAPT significantly reduced the incidence of END and bleeding events in those without large vessel occlusion, while the results were less clear in patients with large vessel occlusion.
- The findings suggest that DAPT may be a safer and more effective treatment option for minor strokes without major occlusions, although further research is needed to confirm these results.
Differences in Acute Expression of Matrix Metalloproteinases-9, 3, and 2 Related to the Duration of Brain Ischemia and Tissue Plasminogen Activator Treatment in Experimental Stroke.
Int J Mol Sci
August 2024
Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ 85004, USA.
Matrix metalloproteinases (MMPs) such as MMP-9, 3, and 2 degrade the cellular matrix and are believed to play a crucial role in ischemic stroke. We examined how the duration of ischemia (up to 4 h) and treatment with recombinant tissue plasminogen activator altered the comparative expression of these MMPs in experimental ischemic stroke with reperfusion. Both prolonged ischemia and r-tPA treatment markedly increased MMP-9 expression in the ischemic hemisphere (all < 0.
View Article and Find Full Text PDFHub-and-Spoke Stroke System: Enhancing Acute Ischemic Stroke Care in the Philippines.
Cerebrovasc Dis Extra
October 2024
Department of Neurology, Stroke and Vascular Neurology Service, Jose R. Reyes Memorial Medical Center, Manila, Philippines.
Introduction: The Hub-and-Spoke stroke system seeks to enhance the efficiency of stroke care by establishing a cohesive network between healthcare facilities providing quality stroke care to patients. This study endeavors to evaluate the effectiveness and characterize the outcomes of acute ischemic stroke patients treated within the Hub-and-Spoke hospital system over 2 years. The assessment focused on thrombolysis rates, mortality, and disability at 3-month follow-up.
View Article and Find Full Text PDFAngioedema After Use of Recombinant Tissue-Type Plasminogen Activators in Stroke.
Stroke
August 2024
Department of Allergology (E.M.H., A.A.J.M.v.d.V., R.G.P.), University Medical Center Groningen, University of Groningen, Netherlands.
Article Synopsis
- Angioedema can occur without hives as a serious complication of r-tPA treatments like alteplase and tenecteplase, potentially causing airway issues that may require intubation.
- *Current guidelines recommend addressing this by targeting the histamine pathway, but the article argues it should actually be treated by focusing on the bradykinin pathway instead.
- *The manuscript calls for an update to the American Heart Association/American Stroke Association guidelines to enhance the treatment of r-tPA-induced angioedema and prevent serious outcomes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!