| |  Online-Ressource |
|---|
| Verfasst von: | Kamogawa, Naruhiko [VerfasserIn]  |
|---|
| | Miwa, Kaori [VerfasserIn] |
|---|
| | Toyoda, Kazunori [VerfasserIn] |
|---|
| | Jensen, Märit [VerfasserIn] |
|---|
| | Inoue, Manabu [VerfasserIn] |
|---|
| | Yoshimura, Sohei [VerfasserIn] |
|---|
| | Fukuda-Doi, Mayumi [VerfasserIn] |
|---|
| | Kitazono, Takanari [VerfasserIn] |
|---|
| | Boutitie, Florent [VerfasserIn] |
|---|
| | Ma, Henry [VerfasserIn] |
|---|
| | Ringleb, Peter A. [VerfasserIn] |
|---|
| | Wu, Ona [VerfasserIn] |
|---|
| | Schwamm, Lee H. [VerfasserIn] |
|---|
| | Warach, Steven [VerfasserIn] |
|---|
| | Hacke, Werner [VerfasserIn] |
|---|
| | Davis, Stephen M. [VerfasserIn] |
|---|
| | Donnan, Geoffrey A. [VerfasserIn] |
|---|
| | Gerloff, Christian [VerfasserIn] |
|---|
| | Thomalla, Götz [VerfasserIn] |
|---|
| | Koga, Masatoshi [VerfasserIn] |
|---|
| | Bendszus, Martin [VerfasserIn] |
|---|
| Titel: | Thrombolysis for wake-up stroke versus non-wake-up unwitnessed stroke |
|---|
| Titelzusatz: | EOS individual patient data meta-analysis |
|---|
| Verf.angabe: | Naruhiko Kamogawa, Kaori Miwa, Kazunori Toyoda, Märit Jensen, Manabu Inoue, Sohei Yoshimura, Mayumi Fukuda-Doi, Takanari Kitazono, Florent Boutitie, Henry Ma, Peter Ringleb, Ona Wu, Lee H. Schwamm, Steven Warach, Werner Hacke, Stephen M. Davis, Geoffrey A. Donnan, Christian Gerloff, Götz Thomalla, Masatoshi Koga, Evaluation of Unknown Onset Stroke Thrombolysis Trials (EOS) Investigators: : Bastian Cheng, Martin Bendszus... |
|---|
| E-Jahr: | 2024 |
|---|
| Jahr: | Mar 2024 |
|---|
| Umfang: | 10 S. |
|---|
| Fussnoten: | Ursprünglich veröffentlicht: 8. März 2024 ; Gesehen am 04.04.2024 |
|---|
| Titel Quelle: | Enthalten in: Stroke |
|---|
| Ort Quelle: | New York, NY : Association, 1970 |
|---|
| Jahr Quelle: | 2024 |
|---|
| Band/Heft Quelle: | 55(2024), 4 vom: Apr., Seite 895-904 |
|---|
| ISSN Quelle: | 1524-4628 |
|---|
| Abstract: | BACKGROUND: Stroke with unknown time of onset can be categorized into 2 groups; wake-up stroke (WUS) and unwitnessed stroke with an onset time unavailable for reasons other than wake-up (non-wake-up unwitnessed stroke, non-WUS). We aimed to assess potential differences in the efficacy and safety of intravenous thrombolysis (IVT) between these subgroups. METHODS: Patients with an unknown-onset stroke were evaluated using individual patient-level data of 2 randomized controlled trials (WAKE-UP [Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke], THAWS [Thrombolysis for Acute Wake-Up and Unclear-Onset Strokes With Alteplase at 0.6 mg/kg]) comparing IVT with placebo or standard treatment from the EOS (Evaluation of Unknown-Onset Stroke Thrombolysis trial) data set. A favorable outcome was prespecified as a modified Rankin Scale score of 0 to 1 at 90 days. Safety outcomes included symptomatic intracranial hemorrhage at 22 to 36 hours and 90-day mortality. The IVT effect was compared between the treatment groups in the WUS and non-WUS with multivariable logistic regression analysis. RESULTS: Six hundred thirty-four patients from 2 trials were analyzed; 542 had WUS (191 women, 272 receiving alteplase), and 92 had non-WUS (42 women, 43 receiving alteplase). Overall, no significant interaction was noted between the mode of onset and treatment effect (P value for interaction=0.796). In patients with WUS, the frequencies of favorable outcomes were 54.8% and 45.5% in the IVT and control groups, respectively (adjusted odds ratio, 1.47 [95% CI, 1.01-2.16]). Death occurred in 4.0% and 1.9%, respectively (P=0.162), and symptomatic intracranial hemorrhage in 1.8% and 0.3%, respectively (P=0.194). In patients with non-WUS, no significant difference was observed in favorable outcomes relative to the control (37.2% versus 29.2%; adjusted odds ratio, 1.76 [0.58-5.37]). One death and one symptomatic intracranial hemorrhage were reported in the IVT group, but none in the control. CONCLUSIONS: There was no difference in the effect of IVT between patients with WUS and non-WUS. IVT showed a significant benefit in patients with WUS, while there was insufficient statistical power to detect a substantial benefit in the non-WUS subgroup. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: CRD42020166903. |
|---|
| DOI: | doi:10.1161/STROKEAHA.123.043358 |
|---|
| URL: | Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.
Volltext: https://doi.org/10.1161/STROKEAHA.123.043358 |
|---|
| | Volltext: https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.043358 |
|---|
| | DOI: https://doi.org/10.1161/STROKEAHA.123.043358 |
|---|
| Datenträger: | Online-Ressource |
|---|
| Sprache: | eng |
|---|
| Sach-SW: | Brain ischemia |
|---|
| | Female |
|---|
| | Fibrinolytic agents |
|---|
| | Humans |
|---|
| | Intracranial hemorrhages |
|---|
| | intravenous alteplase |
|---|
| | intravenous thrombolysis |
|---|
| | ischemic stroke |
|---|
| | Stroke |
|---|
| | Thrombolytic therapy |
|---|
| | Tissue plasminogen activator |
|---|
| | Treatment outcome |
|---|
| | unknown-onset stroke |
|---|
| | wake-up stroke |
|---|
| K10plus-PPN: | 1885050372 |
|---|
| Verknüpfungen: | → Zeitschrift |
|---|
Thrombolysis for wake-up stroke versus non-wake-up unwitnessed stroke / Kamogawa, Naruhiko [VerfasserIn]; Mar 2024 (Online-Ressource)
