Efficacy and Safety of Tenecteplase in the Treatment of Acute Branch Atheromatous Disease: A Retrospective Multicenter Case-Control Study.

IF 4.8 3区医学 Q1 CLINICAL NEUROLOGY

Neurology and Therapy Pub Date : 2025-10-01 Epub Date: 2025-08-31 DOI:10.1007/s40120-025-00807-w

Lili Zhu, Shengqi Fu, Ying Zhang, Baoyang Shi, Haoran Li, Fanchao Meng, Peng Ji, Dongya Zhang, Yanjun Zhang, Yuan Xu, Bo Jiang, Xiaofei Gao, Lijuan Liu, Weifeng Chen, Li Ruan, Shaolei Zhang, Yang Yang

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引用次数: 0

Abstract

Introduction: Branch atheromatous disease (BAD) is a common subtype of acute ischemic stroke characterized by atherosclerosis. Patients with BAD are highly prone to early neurological deterioration. Intravenous thrombolysis can restore blood flow. We investigated the efficacy of tenecteplase (TNK) intravenous thrombolysis in BAD treatment.

Methods: We retrospectively examined data from patients with BAD admitted to 13 hospitals in Zhengzhou between January 2020 and December 2024. Participants were categorized into TNK and dual antiplatelet therapy (DAPT) groups. Propensity score matching was performed to reduce subgroup heterogeneity.

Results: We included 1980 patients (TNK: 621, DAPT: 1359) matched in 522 pairs of participants. After propensity score matching, intravenous TNK administration within 4.5 h of stroke onset was associated with reduced early neurological deterioration (unadjusted odds ratio [OR] = 1.796, 95% confidence interval [CI]: 1.303-2.477, P < 0.001) and improved clinical outcomes 90 days post-stroke. In the TNK group, more patients achieved good functional prognosis (modified Rankin scale [mRS] 0-1; unadjusted OR = 0.648, 95% CI 0.506-0.830, P < 0.001) and were functionally independent (mRS 0-2) at 90 days post-stroke (unadjusted OR = 0.725, 95% CI 0.546-0.963, P = 0.026). The dependence rate (mRS ≥ 4) in the TNK group was significantly lower than that in the DAPT group (unadjusted OR = 1.576, 95% CI 1.062-2.339, P = 0.024). Mortality (unadjusted OR = 2.351, 95% CI 0.605-9.143; P = 0.217), symptomatic intracranial hemorrhage (unadjusted OR = 0.595, 95% CI 0.215-1.650; P = 0.319), and other bleeding events (unadjusted OR = 1.371, 95% CI 0.680-2.764; P = 0.378) did not differ significantly.

Conclusion: TNK intravenous thrombolysis may be a safe and effective treatment for patients with BAD.

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替奈普酶治疗急性支动脉粥样硬化疾病的有效性和安全性：一项回顾性多中心病例对照研究。

分支动脉粥样硬化病（BAD）是急性缺血性脑卒中中常见的以动脉粥样硬化为特征的亚型。BAD患者极易出现早期神经功能恶化。静脉溶栓可以恢复血液流动。我们研究了替尼替普酶（TNK）静脉溶栓治疗BAD的疗效。方法：我们回顾性分析了2020年1月至2024年12月期间郑州13家医院收治的BAD患者的数据。参与者被分为TNK组和双重抗血小板治疗组（DAPT）。进行倾向评分匹配以减少亚组异质性。结果：我们纳入了1980例患者（TNK: 621, DAPT: 1359），在522对参与者中匹配。经倾向评分匹配，卒中发生后4.5 h内静脉给予TNK与早期神经功能恶化减少相关（未经调整的优势比[OR] = 1.796, 95%可信区间[CI]: 1.304 -2.477， P）结论：TNK静脉溶栓可能是一种安全有效的治疗BAD患者的方法。

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

Neurology and Therapy CLINICAL NEUROLOGY-

CiteScore

5.40

自引率

8.10%

发文量

103

审稿时长

6 weeks

期刊介绍： Aims and Scope Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice. Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. 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