Thrombolytic therapy for stroke in patients with preexisting cognitive impairment

Kei Murao, Didier Leys, Agnès Jacquin, Takanari Kitazono, Régis Bordet, Yannick Béjot, Kazumi Kimura, Olivier Godefroy, Yoshinobu Wakisaka, Solène Moulin, Tetsuro Ago, Igor Sibon, Stéphanie Bombois, Jean Louis Mas, Hilde Hénon, Florence Pasquier, Maurice Giroud, Charlotte Cordonnier, Yasushi Okada

研究成果: ジャーナルへの寄稿記事

11 引用 (Scopus)

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Objective: We aimed to evaluate the influence of prestroke cognitive impairment (PSCI) on outcomes in stroke patients treated with IV recombinant tissue plasminogen activator (rtPA). Methods: OPHELIE-COG was a prospective observational multicenter study conducted in French and Japanese patients treated with IV rtPA for cerebral ischemia. The preexisting cognitive status was evaluated by the short version of the Informant Questionnaire on Cognitive Decline in the Elderly. PSCI was defined as a mean score >3. The primary endpoint was a favorable outcome (modified Rankin Scale [mRS] score 0-1) after 3 months. Secondary endpoints were symptomatic intracerebral hemorrhage (sICH), mRS scores 0-2, and mortality at 3 months. We performed a pooled analysis with Biostroke and Strokdem. Results: Of 205 patients, 62 (30.2%) met criteria for PSCI. They were 11 years older (p <0.001). Although they had more sICH and were less frequently independent after 3 months, they did not differ for any endpoint after adjustment for age, baseline NIH Stroke Scale score, and onset-toneedle time: sICH (odds ratio [OR] 2.78; 95%confidence interval [CI] 0.65-11.86), mRS 0-1 (OR 0.82; 95% CI 0.41-1.65), mRS 0-2 (OR 0.62; 95% CI 0.28-1.37), death (OR 0.40; 95% CI 0.08-2.03). The pooled analysis found no association of PSCI with any endpoint. Conclusions: Ischemic stroke patients with PSCI should receive rtPA if they are eligible. This conclusion cannot be extended to severe cognitive impairment or severe strokes. Classification of evidence: This study provides Class IV evidence that in patients with PSCI presenting with acute ischemic stroke, IV rtPA improves outcomes.

元の言語英語
ページ(範囲)2048-2054
ページ数7
ジャーナルNeurology
82
発行部数23
DOI
出版物ステータス出版済み - 6 10 2014

    フィンガープリント

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

これを引用

Murao, K., Leys, D., Jacquin, A., Kitazono, T., Bordet, R., Béjot, Y., ... Okada, Y. (2014). Thrombolytic therapy for stroke in patients with preexisting cognitive impairment. Neurology, 82(23), 2048-2054. https://doi.org/10.1212/WNL.0000000000000493