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

doi:10.1161/STROKEAHA.114.006570

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

42 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 language	English
Journal	Stroke; a journal of cerebral circulation
Volume	45
Issue number	10
Pages (from-to)	3070-2
Number of pages	3
ISSN	0039-2499
DOIs	https://doi.org/10.1161/STROKEAHA.114.006570
Publication status	Published - 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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Schmitz, M. L., Simonsen, C. Z., Hundborg, H., Christensen, H., Ellemann, K., Geisler, K., Iversen, H., Madsen, C., Rasmussen, M-J., Vestergaard, K., Andersen, G., & Johnsen, S. P. (2014). Acute ischemic stroke and long-term outcome after thrombolysis: nationwide propensity score-matched follow-up study. Stroke; a journal of cerebral circulation, 45(10), 3070-2. https://doi.org/10.1161/STROKEAHA.114.006570

Schmitz, ML, Simonsen, CZ, Hundborg, H, Christensen, H, Ellemann, K, Geisler, K, Iversen, H, Madsen, C, Rasmussen, M-J, Vestergaard, K, Andersen, G & Johnsen, SP 2014, 'Acute ischemic stroke and long-term outcome after thrombolysis: nationwide propensity score-matched follow-up study', Stroke; a journal of cerebral circulation, vol. 45, no. 10, pp. 3070-2. https://doi.org/10.1161/STROKEAHA.114.006570

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

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.",

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",

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

note = "{\textcopyright} 2014 American Heart Association, Inc.",

year = "2014",

month = oct,

doi = "10.1161/STROKEAHA.114.006570",

language = "English",

volume = "45",

pages = "3070--2",

journal = "Journal of Stroke",

issn = "0039-2499",

publisher = "Lippincott Williams & Wilkins",

number = "10",

}

TY - JOUR

T1 - Acute ischemic stroke and long-term outcome after thrombolysis

T2 - nationwide propensity score-matched follow-up study

AU - Schmitz, Marie Louise

AU - Simonsen, Claus Ziegler

AU - Hundborg, Heidi

AU - Christensen, Hanne

AU - Ellemann, Karsten

AU - Geisler, Karin

AU - Iversen, Helle

AU - Madsen, Charlotte

AU - Rasmussen, Mary-Jette

AU - Vestergaard, Karsten

AU - Andersen, Grethe

AU - Johnsen, Soeren P

PY - 2014/10

Y1 - 2014/10

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Denmark

KW - Female

KW - Fibrinolytic Agents

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Propensity Score

KW - Proportional Hazards Models

KW - Recurrence

KW - Registries

KW - Stroke

KW - Thrombolytic Therapy

KW - Tissue Plasminogen Activator

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1161/STROKEAHA.114.006570

DO - 10.1161/STROKEAHA.114.006570

M3 - Journal article

C2 - 25190440

VL - 45

SP - 3070

EP - 3072

JO - Journal of Stroke

JF - Journal of Stroke

SN - 0039-2499

IS - 10

ER -

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

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Keywords

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