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Safety of standard-dose (.9-mg/kg) alteplase intravenous thrombolysis for acute ischemic stroke in Afro-Caribbeans, French West Indies.
Chausson, Nicolas; Olindo, Stéphane; Joux, Julien; Saint-Vil, Martine; Aveillan, Mathieu; Smadja, Didier.
Afiliação
  • Chausson N; Department of Neurology, University Hospital Fort-de-France, Fort-de-France, Martinique, France. Electronic address: nicolaschausson@hotmail.com.
  • Olindo S; Department of Neurology, University Hospital Fort-de-France, Fort-de-France, Martinique, France.
  • Joux J; Department of Neurology, University Hospital Fort-de-France, Fort-de-France, Martinique, France.
  • Saint-Vil M; Department of Neurology, University Hospital Fort-de-France, Fort-de-France, Martinique, France.
  • Aveillan M; Department of Neuroradiology, University Hospital Fort-de-France, Fort-de-France, Martinique, France.
  • Smadja D; Department of Neurology, University Hospital Fort-de-France, Fort-de-France, Martinique, France.
J Stroke Cerebrovasc Dis ; 23(7): 1776-80, 2014 Aug.
Article em En | MEDLINE | ID: mdl-24957315
BACKGROUND: Pharmacobiologic data suggested that people of African ancestry were more sensitive to the recombinant tissue plasminogen activator, alteplase, than Caucasians. Furthermore, the higher incidences of hypertension and diabetes mellitus in black populations could contribute to a higher cerebral bleeding risk. However, standard-dose (.9-mg/kg) alteplase safety for stroke has never been evaluated in blacks. This study was undertaken to evaluate standard-dose alteplase safety to treat strokes in an Afro-Caribbean population. METHODS: Parenchymal hemorrhage and symptomatic intracerebral hemorrhage rates in Afro-Caribbean Martinicans given standard-dose alteplase for acute stroke were evaluated based on prospectively collected data from 2007 to 2010 and compared with those from studies on predominantly Caucasian stroke victims. RESULTS: Parenchymal hemorrhage type 2 and symptomatic intracerebral hemorrhages, as defined by the third European Cooperative Acute Stroke Study, respectively, occurred in 15 (10.1%) and 12 (8.1%) of the 148 thrombolyzed Afro-Caribbeans, respectively. This excess bleeding risk (parenchymal hemorrhage type 2) concerned more patients >70 than those 70 years of age or lesser (respectively, 17.6% [13 of 74] vs. 2.7% [2 of 74]). Older age was the only factor significantly associated with a higher parenchymal hemorrhage type 2 risk (P = .02). CONCLUSIONS: The excess hemorrhagic risk after standard-dose alteplase infusion into older Afro-Caribbean patients warrants further study to determine the possible role of cerebral microangiopathy and should be evaluated in different black populations.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Trombolítica / Isquemia Encefálica / Ativador de Plasminogênio Tecidual / Acidente Vascular Cerebral / Fibrinolíticos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Caribe Idioma: En Revista: J Stroke Cerebrovasc Dis Assunto da revista: ANGIOLOGIA / CEREBRO Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Trombolítica / Isquemia Encefálica / Ativador de Plasminogênio Tecidual / Acidente Vascular Cerebral / Fibrinolíticos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Caribe Idioma: En Revista: J Stroke Cerebrovasc Dis Assunto da revista: ANGIOLOGIA / CEREBRO Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos