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Systemic thrombolysis in patients with acute stroke and active cancer: a systematic review and meta-analysis.
Mosconi, Maria Giulia; Capponi, Andrea; Paciaroni, Maurizio.
Afiliación
  • Mosconi MG; Internal and Vascular and Emergency Medicine-Stroke Unit, Università degli Studi di Perugia/Azienda Ospedaliera Santa Maria della Misericordia, 06129, Perugia, Italy. mariagiulia98581@yahoo.it.
  • Capponi A; Emergency Department, University of Florence, Florence, Italy.
  • Paciaroni M; Internal and Vascular and Emergency Medicine-Stroke Unit, Università degli Studi di Perugia/Azienda Ospedaliera Santa Maria della Misericordia, 06129, Perugia, Italy.
Intern Emerg Med ; 18(6): 1843-1850, 2023 09.
Article en En | MEDLINE | ID: mdl-37337013
Cancer patients frequently have concomitant cerebrovascular diseases, which significantly worsen their prognosis. Prospective studies validating intravenous thrombolysis (IVT) safety profile in patients with acute ischemic stroke and active cancer are still lacking. Therefore, we aimed to evaluate IVT's efficacy and safety profile in acute ischemic stroke patients with comorbid active cancer. We included in a meta-analysis all relevant published studies, including patients with acute ischemic stroke with or without active cancer and receiving IVT, according to recommendations for IVT treatment for acute ischemic stroke. The primary outcomes were: any intracerebral hemorrhage, all-cause mortality, and good functional outcome reported as modified Rankin Scale (mRS) ≤ 2 at the end of the scheduled follow-up period. We included 11 studies in the meta-analysis. IVT was not associated with a significant increase in the incidence of intracerebral hemorrhage (OR 1.35; 95% CI 0.85-2.14; I2 76%), nor with a significant increase in death for any cause (OR 1.26; 95% CI 0.91-1.75; I2 71%); furthermore, IVT did not influence mRS between cancer and non-active cancer stroke patients (OR 0.72; 95% CI 0.35-1.49; I2 59%). IVT seems safe and effective in patients with ischemic stroke and concomitant cancer. Due to the low overall quality of the evidence, high-quality randomized controlled trials with adequate sample sizes are needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico / Neoplasias Tipo de estudio: Clinical_trials / Guideline / Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Intern Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA / MEDICINA INTERNA Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
Texto completo
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Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico / Neoplasias Tipo de estudio: Clinical_trials / Guideline / Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Intern Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA / MEDICINA INTERNA Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia