In a stroke cohort with incident hypertension; are more women than men likely to be excluded from recombinant tissue-type Plasminogen Activator (rtPA)?

Gainey, Jordan; Brechtel, Leanne; Konklin, Sarah; Madeline, Lee; Lowther, Ervin; Blum, Brice; Nathaniel, Thomas I.

doi:10.1016/j.jns.2018.02.016

Cited by 33 publications

(28 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The stroke registry used in this study has been described in previous studies. 28,30,32,33 We collected data on patients' medical history including dyslipidemia, coronary artery disease (CAD), atrial fibrillation/atrial flutter, carotid stenosis, pregnancy, depression, diabetes, drug or alcohol abuse, family history of stroke, congestive heart failure, HTN, migraine, obesity, prior stroke, prior TIA, prosthetic heart valve, peripheral vascular disease (PVD), chronic renal disease, sickle cell, sleep apnea, hormone replacement therapy, and history or smoking. In addition, we collected data on ambulation.…”

Section: Methodsmentioning

confidence: 99%

The Association Between an Antecedent of Transient Ischemic Attack Prior to Onset of Stroke and Functional Ambulatory Outcome

Poupore

Strat

Mackey

et al. 2020

Clin Appl Thromb Hemost

Self Cite

View full text Add to dashboard Cite

Background: Specific clinical risk factors linked to transient ischemic attack (TIA) could affect functional ambulatory outcome following thrombolytic therapy in patients having ischemic stroke with a prior TIA (TIA-ischemic stroke). This issue was investigated in this study. Methods: We retrospectively analyzed data from 6379 ischemic stroke patients of which 1387 presented with an antecedent TIA prior to onset of stroke. We used logistic regression model to identify demographic and clinical risk factors that are associated with functional ambulatory outcome in patients with TIA-ischemic stroke treated with thrombolytic therapy. Results: In a population of TIA-ischemic stroke who received recombinant tissue plasminogen activator, patients with a history of stroke (odds ratio [OR] = 3.229, 95% confidence interval [CI] = 1.494-6.98, P = .003) were associated with increasing odds of improvement in functional ambulation, while the female gender (OR = 0.462, 95% CI = 0.223-0.956, P = .037) was associated with reducing odds of improvement. In the non-TIA group, dyslipidemia (OR = 1.351, 95% CI = 1.026-1.781, P = .032) and blood glucose (OR = 1.003, 95% CI = 1.0-1.005, P = .041) were associated with the increasing odds of improvement while older patients (OR = 0.989, 95% CI = 0.98-0.999, P = .029) with heart failure (OR = 0.513, 95% CI = 0.326-0.808, P = .004) and higher lipid level (OR = 0.834, 95% CI = 0.728-0.955, P = .009) were associated with reducing odds of improvement in ambulation. Conclusion: In a population of TIA-ischemic stroke with thrombolytic therapy and a clearly defined TIA without focal ischemic injury, regardless of associated clinical risk factors, a TIA prior to a stroke is not associated with reducing odds of improved ambulatory outcome, except in female patients with TIA-ischemic stroke.

show abstract

Section: Methodsmentioning

confidence: 99%

The Association Between an Antecedent of Transient Ischemic Attack Prior to Onset of Stroke and Functional Ambulatory Outcome

Poupore

Strat

Mackey

et al. 2020

Clin Appl Thromb Hemost

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our analysis was conducted on anonymous subjects using retrospective data from a regional stroke center's registry and consents were obtained for all participants following 14 days of stroke recovery. The registry has been described in previous studies [13][14][15]. Our data analysis complies with the STROBE guidelines for cohort studies [16].…”

Section: Methodsmentioning

confidence: 91%

“…Precisely, in the adjusted analysis, female stroke patients with age greater than 80 years of age, previous stroke, and atrial fibrillation were associated with a non-improvement in their ambulatory status. These factors are known to influence functional outcome in longitudinal studies and are more frequent in female stroke patients [15,[32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Prognostic models for ambulatory recovery functions in acute ischemic stroke patients with thrombolysis therapy

Scalise

Gainey

Bailes

et al. 2018

Preprint

Self Cite

View full text Add to dashboard Cite

Background. The purpose of this study was to develop models to predict the recovery of ambulatory functions taking into account the capability of the motor system to functionally reorganize in response to thrombolysis therapy. Methods. We predicted ambulatory functions recovery using retrospective data from a stroke registry of acute ischemic stroke patients who received thrombolysis therapy. Multivariate regression was used to construct the models. Multicollinearity and significant interactions were examined using variance inflation factors, while a Cox & Snell classification were applied to check the fitness of each model. Results. The models correctly predicted clinical variables that were associated with an improvement or non-improvement in functional ambulatory outcome. Broca’s aphasia (OR = 2.270, P = 0.002, CI =1.34-3.83) was associated with improved functional outcome at discharge, while patients aged 80 years or older (OR = 0.942, P = <0.001, CI =0.92-0.96), patients with congestive heart failure (OR = 0.496, P = 0.040, CI = 0.25-0.97), higher NIHSS (OR=0.876, P = 0.001, CI = 0.80-0.95), taking antihypertensive medication (OR = 0.436, P = 0.023, CI = 0.21-0.89) were not associated with improved ambulatory functional outcome with thrombolysis. The discriminating ability for the model was 74.2% for the total population, 71.7% for the rtPA group, and 72.2% for the no-rtPA group indicating strong performance. Conclusion. Prognostic models that can predict improved functional ambulatory outcome in thrombolysis therapy can be beneficial in the care of stroke patients. Our models predicted improved functional recovery of Broca’s aphasia after thrombolysis therapy, suggesting a future potential to evaluate motor speech area after stroke.

show abstract

“…Data within the Greenville Health System (GHS) stroke registry has been standardized according to the "Get with The Guidelines" (GWTG) stroke registry formed by the American Heart Association (AHA). Details in the ascertainment and data collection have previously been described [22][23][24]. Briefly, data was collected from 1466 ischemic stroke patients admitted to the stroke Unit of GHS between January 2014 and June 2016 with a diagnosis of acute ischemic stroke.…”

Section: Methodsmentioning

confidence: 99%

Clinical Risk Factors that Predict Functional Recovery in Ischemic Stroke Patients with Pre-Stroke Depression

Wormack¹,

Blum²,

Bailes³

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background. Specific clinical risk factors that may be associated with ambulatory outcome following thrombolysis therapy in ischemic stroke patients with pre-stroke depression is not fully understood. This was investigated. Methods. Multivariate analyses were performed to identify predictors of functional ambulatory outcomes. Patient demographics and clinical risk factors served as predictive variables, while improvement or no improvement in ambulatory outcome was considered as the primary outcome. Results. A total of 595 of these patients received rtPA of which 310 patients presented with pre-stroke depression, 217 had no improvement in functional outcome, while 93 patients presented with an improvement in functional outcome. Carotid artery stenosis (OR= 11.577, 95% CI, 1.281 -104.636, P=0.029) and peripheral vascular disease (OR= 18.040, 95% CI, 2.956-110.086, P=0.002) were more likely to be associated with an improvement in ambulation. Antihypertensive medications (OR= 7.810, 95% CI, 1.401 -43.529, P=0.019), previous TIA (OR= 0.444, 95% CI, 0.517 -0.971, P=0.012), and congestive heart failure (OR= 0.217, 95% CI, 0.318 -0.402, P=0.030) were associated with a no improvement in ambulation. Conclusion. After adjustment for covariates, more clinical risk factors were associated with no improvement when compared with improvement in functional outcome following thrombolysis therapy in an acute ischemic stroke population with pre-stroke depression.

show abstract

In a stroke cohort with incident hypertension; are more women than men likely to be excluded from recombinant tissue-type Plasminogen Activator (rtPA)?

Cited by 33 publications

References 57 publications

The Association Between an Antecedent of Transient Ischemic Attack Prior to Onset of Stroke and Functional Ambulatory Outcome

The Association Between an Antecedent of Transient Ischemic Attack Prior to Onset of Stroke and Functional Ambulatory Outcome

Prognostic models for ambulatory recovery functions in acute ischemic stroke patients with thrombolysis therapy

Clinical Risk Factors that Predict Functional Recovery in Ischemic Stroke Patients with Pre-Stroke Depression

Contact Info

Product

Resources

About