Low Dose Aspirin Initiation 18 Hours After Thrombolytic Therapy in Acute Ischemic Stroke.

IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY
Aubrey Murphy, Leslie A Hamilton, Kalene Farley, Shaun A Rowe, Thomas Christianson, Brittny Medenwald
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引用次数: 0

Abstract

Objectives: To investigate the safety of administering low-dose aspirin (81 mg) 18 hours after intravenous thrombolytic therapy.

Methods: This is a retrospective cohort investigation. Individuals received either alteplase or tenecteplase for acute ischemic stroke followed by aspirin 81 mg (after follow-up imaging). An institutional change moved follow-up post-thrombolytic CT scans to 18 hours, and qualifying patients were grouped based on whether they received aspirin ≤24 hours or >24 hours. Chart reviews were conducted to assess the primary outcome of new or worsening intracranial hemorrhage, as well as secondary outcomes of change in stroke scale scores at discharge and 3 months, lengths of stay, favorable outcomes at 3 months, hospital readmission, and mortality.

Results: Out of 350 patients screened, 130 qualified for inclusion-50 of whom received aspirin ≤24 hours (mean 21.1 hours, SD±6.2), and 80 who received aspirin >24 hours (mean 34 hours, SD±8.2). Only 1 new intracranial bleed occurred following aspirin administration in the >24-hour group. No statistically significant differences were observed in any of the secondary outcomes, although there was higher mortality (3/50 vs. 2/80, P =0.372) and shorter hospital length of stay (median difference -1.0 day, P =0.0336) in the <24 hours group.

Conclusions: Low-dose aspirin administration sooner than 24 hours following thrombolytic therapy did not increase bleeding events. Sooner aspirin administration after ischemic stroke can potentially enhance the prevention of secondary embolization and did not demonstrate worse clinical outcomes; however, further randomized controlled trials are needed.

急性缺血性脑卒中患者在接受溶栓治疗 18 小时后开始服用小剂量阿司匹林。
目的:研究静脉溶栓治疗 18 小时后服用低剂量阿司匹林(81 毫克)的安全性:研究静脉溶栓治疗 18 小时后服用低剂量阿司匹林(81 毫克)的安全性:这是一项回顾性队列调查。急性缺血性脑卒中患者接受阿替普酶或替奈替普酶治疗后(随访成像后)服用阿司匹林 81 毫克。机构改革将溶栓后CT扫描的随访时间延长至18小时,合格患者根据接受阿司匹林治疗的时间是≤24小时还是>24小时进行分组。对病历进行审查,以评估新发或恶化的颅内出血这一主要结果,以及出院时和 3 个月后中风量表评分变化、住院时间、3 个月后的良好结果、再入院情况和死亡率等次要结果:在 350 名接受筛查的患者中,130 人符合纳入条件,其中 50 人接受阿司匹林治疗的时间≤24 小时(平均 21.1 小时,SD±6.2),80 人接受阿司匹林治疗的时间大于 24 小时(平均 34 小时,SD±8.2)。服用阿司匹林>24 小时组仅有 1 例新发颅内出血。结论组的死亡率较高(3/50 对 2/80,P=0.372),住院时间较短(中位数差异-1.0 天,P=0.0336),但在所有次要结果中均未观察到有统计学意义的差异:溶栓治疗后 24 小时内服用小剂量阿司匹林不会增加出血事件。缺血性脑卒中后更快地服用阿司匹林有可能加强对继发性栓塞的预防,而且临床预后也不会变差;但是,还需要进一步的随机对照试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurologist
Neurologist 医学-临床神经学
CiteScore
1.90
自引率
0.00%
发文量
151
审稿时长
2 months
期刊介绍: The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.
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