Safety of IV thrombolysis in acute ischemic stroke related to Chagas disease.
Neurology
; 81(20): 1773-5, 2013 Nov 12.
Article
em En
| MEDLINE
| ID: mdl-24097814
OBJECTIVE: To determine the rate of symptomatic intracranial hemorrhage (SIH) and in-hospital mortality among patients with acute ischemic stroke related to Chagas disease (CD) treated with IV tissue plasminogen activator (TPA). METHODS: In this retrospective cohort study, consecutive stroke patients treated with IV TPA and routinely tested for CD were retrospectively selected from a single-center, hospital-based, prospective registry of acute stroke patients from 2001 to 2012. Demographic and clinical data were obtained from the registry as well as in-hospital mortality. CT scans were blindly reviewed to assess the occurrence of hemorrhagic transformation. Among acute stroke patients who received IV TPA, we compared those with and without a positive serology for CD. RESULTS: Among 240 patients treated with IV TPA, 174 had serologic testing for CD available. Of those, 24 patients (13.8%) had positive serology for CD. Patients with CD more frequently had heart failure (45.8% vs 14.7%; p < 0.01) and higher admission NIH Stroke Scale scores (19 [15-21] vs 13 [8-19]; p < 0.01) than patients with negative serology. The rates of SIH (4.2% vs 5.3%; odds ratio: 0.77; 95% confidence interval: 0.09-6.46; p = 0.99) and in-hospital death (16.7% vs 11.3%; odds ratio: 1.57; 95% confidence interval: 0.48-5.12; p = 0.50) were not higher among patients with CD. CONCLUSION: In the largest published series of patients with CD-related stroke treated with IV TPA, we have observed that IV thrombolysis was safely performed and showed no increase of SIH. The diagnosis of CD should not preclude IV thrombolysis in these patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Chagas
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Ativador de Plasminogênio Tecidual
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Acidente Vascular Cerebral
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Fibrinolíticos
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurology
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Estados Unidos