:: Volume 11, Issue 2 (4-2024) ::
2024, 11(2): 62-69 Back to browse issues page
The Effect of Intravenous Alteplase on Patients with Acute Ischemic Stroke: A Clinical Trial Study in a Specialty Hospital in Ilampital in Ilam
Milad MohamadYari , Aryoobarzan Rahmatian , Monireh Azizi , Khairollah Asadollahi
Abstract:   (411 Views)
Introduction: Strokes rank among the leading causes of death and disability worldwide, with acute ischemic stroke (AIS) on the rise in Iran. Thrombolytic drugs constitute a primary treatment for ischemic stroke. However, due to limited studies in Iran, there exists hesitation among physicians regarding their administration. This study aims to assess the efficacy of these drugs on AIS patients.
Methods: In a clinical trial, 80 patients with ischemic stroke were divided into treatment and control groups. Both groups were assessed upon admission and 72 hours later using the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) scores at discharge. The treatment group received Alteplase (0.9mg/kg), while the control group received standard care. Statistical analysis was performed using SPSS 20.
Results: The mean NIHSS ± SD scores at admission and 72 hours later in the treatment group were 10.0±3.51 and 4.55±8.75, respectively, compared to 8.53±3.52 and 7.88±9.21 in the control group, showing a significant difference in favor of the treatment group (P < 0.001). Similarly, the mean mRS± SD score in the treatment group was 1.68±1.79, significantly lower than the control group's 3.15±1.61 (P < 0.001).
Conclusion:  Intravenous Alteplase administration proved effective in treating patients with ischemic stroke, significantly reducing neurological complications and disabilities compared to standard medical care.
Keywords: Cerebrovascular Disorders, Stroke, Tissue Plasminogen Activator, Alteplase, National Institutes of Health Stroke Scale
Full-Text [PDF 200 kb]   (81 Downloads)    
Type of Study: Research | Subject: Neurology
Received: 2023/12/6 | Accepted: 2024/04/29 | Published: 2024/04/22
References
1. Ropper A, A Samuels M, P.Klein J, Prasad S. Adams and Victor's Principles of Neurology 12th edition. McGraw Hill, New york, 2023, P:775.
2. B Katan M, Luft A. Global burden of stroke. Semin Neurol. (2018) 38:208–11. doi: 10.1055/s-0038-1649503.
3. Brainin M, Olsen TS, Chamorro A, Diener HC, Ferro J, Hennerici MG, et al. Organization of stroke care: education, referral, emergency management and imaging, stroke units and rehabilitation. Cerebrovasc Dis. 2004; 17: 1-14.
4. Azarpazhooh MR, Etemadi MM, Donnan GA, Mokhber N, Majdi MR, Ghayour-Mobarhan M, et al. Excessive incidence of stroke in Iran, evidence from Mashhad stroke incidence study (MSIS), A population based study of stroke in the middle east. Stroke. 2010; 41: e3-e10.
5. Borhani-Haghighi A, Safari R, Heydari ST, Soleimani F, Sharifian M, Yektaparast-Kashkuli S, et al. Hospital Mortality Associated with Stroke in Southern Iran. Iranian Journal of Medical Sciences. 2013; 38 (4): 314-320
6. Araujo DV, Teich V, Passos RB, Martins SC. Analysis of the Cost-Effectiveness of Thrombolysis with Alteplase in Stroke. Arq Bras Cardiol. 2010 Jul; 95(1):12-20.
7. Stroke Unit Trialists’ Collaboration. Organized inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev. 2013 Sep 11; (9): CD000197.
8. Jauch E, Saver J, AdamsJr H, Bruno A, Connors JJ, Demaerschalk B, et al. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44:870-947.
9. Ortiz GA, L Sacco R. National Institutes of Health Stroke Scale (NIHSS). In Wiley StatsRef: Statistics Reference Online. [DOI:10.1002/9781118445112.stat06823]
10. Chapman SN, Mehndiratta P, Johansen MC, McMurry TL, Johnston KC, Southerland AM. Current perspectives on the use of intravenous recombinant tissue plasminogen activator (tPA) for treatment of acute ischemic stroke. Vasc Health Risk Manag. 2014; 10: 75-87.
11. Ghandehari K. Design of a standard Iranian protocol of Intravenous thrombolysis with tissue plasminogen activator: A national project. Iran J Neurol. 2013; 12(2): 72–74.
12. Vuletic V,Basic S, Sporis D. Our preliminary experiences with intravenous thrombolysis [Poster abstract]. Journal of the Neurological Sciences. 2009 Oct; 285(Suppl 1): S226.
13. Vukasinovic NP, Jolic SZ. Intravenous tissue-type plasminogen activator therapy for ischemic stroke: Nis stroke team experience November 2006 – May 2009 [Poster abstract]. Journal of the Neurological Sciences. 2009 Oct; 285(Suppl 1): S227.
14. Andrade LFP, Moraes HP, Albuquerque LC, Rodrigues NEP. Case reports over four years of intravenous thrombolytic therapy in stroke unit of the Hospital do Servidor Pu´ blico Estadual De S˜ao Paulo [poster abstract]. Journal of the Neurological Sciences. 2009 Oct; 285(Suppl 1): S226-S227.
15. Khurana D, Das B, Kumar A, Kumar AS, Khandelwal L, Lal V, et al. Temporal Trends in Intravenous Thrombolysis in Acute Ischemic Stroke: Experience from a Tertiary Care Center in India. Journal of Stroke and Cerebrovascular Diseases 2017 Jun; 26: 1266-1273.
16. Hacke W, Kaste M, Fieschi C, Kummer RV, Davalos A, Meier D, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischemic stroke (ECASS II). The Lancet. 1998 Oct; 352: 1245-1251.
17. Sahuc-Rodrigues P, Sagui E, Wybrecht D, Veyrières JB, Gazzola S, Dagain A, et al. Intravenous thrombolytic therapy for acute anterior ischemic stroke: Experience at the French Military Teaching Hospital in Toulon from 2003 to 2014. Rev Neurol (Paris). 2018 Mar; 174(3): 125-136.
18. Ghiasian M, Daneshyar S, Lotfiyar M. Assessment of One- year Prognosis in Patients with Stroke. J Mazandaran Univ Med Sci. 2019; 28 (168): 172-176 (Persian).
19. Turc G, Isabel C, Calvet D. Intravenous thrombolysis for acute ischemic stroke. Diagn Interv Imaging. 2014 Dec; 95(12): 1129-33.
20. Kutluk K, Kaya D, Afsar N, Arsava EM, Ozturk V, Uzuner N, et al. Analyses of the Turkish National Intravenous Thrombolysis Registry. J Stroke Cerebrovasc Dis. 2016 May; 25(5): 1041-1047.
21. Liu CH, Lin JR, Liou CW, Lee JD, Peng TI, Lee M, et al. Causes of Death in Different Subtypes of Ischemic and Hemorrhagic Stroke. Angiology. 2018 Aug; 69(7): 582-590.
22. Groppa S, Zota E, Grigor V, More V. Thrombolysis in Republic of Moldova [Poster abstract]. Journal of the Neurological Sciences 2009 Oct; 285(Suppl 1): S227.


XML     Print



Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 11, Issue 2 (4-2024) Back to browse issues page