TY - JOUR
T1 - Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score-Matched Follow-Up Study
AU - Schmitz, Marie Louise
AU - Simonsen, Claus Z
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
N1 - © 2014 American Heart Association, Inc.
PY - 2014/9/4
Y1 - 2014/9/4
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.
U2 - 10.1161/STROKEAHA.114.006570
DO - 10.1161/STROKEAHA.114.006570
M3 - Journal article
C2 - 25190440
SN - 0039-2499
VL - 45
SP - 3070
EP - 3072
JO - Stroke
JF - Stroke
IS - 10
ER -