Analysis of factors influencing the early efficiency of systemic thrombolytic therapy for ischemic stroke

Abstract

he paper shows the urgency of enhancing the efficiency of systemic thrombolytic therapy (TLT).Objective: to study the impact of age, gender, smoking, atrial fibrillation, glucose levels at admission and the time of initiation of TLT after ischemic stroke onset on its early efficiency. Patients and methods. The efficiency of TLT was analyzed in 44 patients with ischemic stroke. Their mean age was 59.5 (range 53.0–70.0) years; 43.2% were smokers; persistent and paroxysmal atrial fibrillation was seen in 27 and 7% of the patients, respectively. The interval between the onset of the disease onset and thrombolysis averaged 187.5 (range 152.5–217.5) min. The criterion for the early efficiency of TLT was a ≥4 score reduction in the severity of neurological deficit according to the National Institute of Health Stroke Scale (NIHSS) on day 7. The mean NIHSS score at admission was 11.5 (range 9–16.5%). Neurological deficit at hospital admission was higher in patients with cardioembolic stroke – 14.0 (range 12.0–18.0) scores.Results. Improvement was observed in 66% of the patients on day 7. The mean NIHSS score on day 7 was 6.0 (range 4–12). There was a significant correlation between the high early efficiency of TLT, time to start thrombolysis, and baseline blood glucose level. The influence of other factors calls for further investigations in a larger patient sample.

Keywords

• ischemic stroke
• thrombolytic therapy