Acute ischemic stroke and long-term outcome after thrombolysis: nationwide propensity score-matched follow-up study

Marie Louise Schmitz, Claus Ziegler Simonsen, Heidi Hundborg, Hanne Christensen, Karsten Ellemann, Karin Geisler, Helle Iversen, Charlotte Madsen, Mary-Jette Rasmussen, Karsten Vestergaard, Grethe Andersen, Soeren P Johnsen

48 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding, in intravenous tPA-treated patients when compared with intravenous tPA eligible but nontreated patients with ischemic stroke.

METHODS: We conducted a register-based nationwide propensity score-matched follow-up study among patients with ischemic stroke in Denmark (2004-2011). Cox regression analysis was used to compute adjusted hazard ratios for all outcomes.

RESULTS: Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score-matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long-term mortality (adjusted hazard ratio, 0.66; 95% confidence interval, 0.49-0.88). The long-term risk of recurrent ischemic stroke (adjusted hazard ratio, 1.05; 95% confidence interval, 0.68-1.64) and major bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.24-1.47) did not differ significantly between the intravenous tPA-treated and nontreated patients.

CONCLUSIONS: Treatment with intravenous tPA in patients with ischemic stroke was associated with improved long-term survival.

Original languageEnglish
JournalStroke; a journal of cerebral circulation
Volume45
Issue number10
Pages (from-to)3070-2
Number of pages3
ISSN0039-2499
DOIs
Publication statusPublished - Oct 2014

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Denmark
  • Female
  • Fibrinolytic Agents
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Propensity Score
  • Proportional Hazards Models
  • Recurrence
  • Registries
  • Stroke
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator
  • Treatment Outcome
  • Young Adult

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