Comparison of the effectiveness and side effects of intravenous TPA injection in acute stroke patients between 0 to 4.5 hours and the first 4.5 to 6 hours from the onset of symptoms
Mohammad Bagher Abar1, Mehdi Maghbooli2, Abdoreza Ghoreishi1
1Zanjan University of Medical Sciences, 2Neurology, Zanjan University of Medical Sciences
Objective:
To compare the effectiveness and side effects of intravenous tissue plasminogen activator (TPA) injection in acute stroke patients between 0 to 4.5 hours and the first 4.5 to 6 hours from the onset of symptoms.
Background:
rTPA injection in acute stroke patients between 4.5 to 6 hours from the onset of symptoms has not been approved by health protocol and most of those patients die due to that protocol.
Design/Methods:
This retrospective cohort study of all ischemic stroke patients referred to Valiasr Hospital in Zanjan between 96 and 1400 hospitalizations in the SCU department were examined. Two groups were considered, the delayed group included patients who received intravenous TPA in 4.5 to 6 hours, and the standard group included patients who received intravenous TPA in the first 4.5 hours.NIHSS and MRS between the two groups at the time of admission, at the time of discharge, and after three months were compared .
Results:
Of these 75 subjects, 50 were in the standard group, and 25 were in the delayed group. The average MRS at the first admission, discharge, and 90 days after discharge in the delayed group was 0.6±0.2, 1.7±1.5, and 1.8±1.5, respectively. There was a significant difference between the two standard and delayed groups in terms of the time from the onset of symptoms to referral and the time of TPA injection (P value<0.05) and MRS at the time of the admission. Furthermore, in the delayed group, there were a significant relationship between NIHSS at the first admission and discharge and also MRS at the time of discharge and 90 days after discharge (P value<0.05).
Conclusions:
The effectiveness of injections between 4.5 and 6 hours and injections between 0 and 4.5 hours are not different from each other in terms of complications and mortality.