Clinical Outcomes of Thrombolytic Therapy in Patients with Mild Stroke: A Single-center Experience in a Tertiary Care Institution
Hasan Hüseyin Karadeli
, Ruken Şimşekoğlu
Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalçin City Hospital, Clinic of Neurology, Istanbul, Turkey
Keywords: Mild stroke, NIHSS, modified rankin scale, thrombolytic treatment, iv-tPA
Abstract
Objective: Mild stroke is used to describe patients with stroke having a National Institutes of Health Stroke Scale (NIHSS) score of 0-6. However, there is still no clear decision regarding the application of intravenous (iv) recombinant tissue plasminogen activator (iv-tPA) to patients who were admitted with an acute ischemic stroke and were in the mild stroke category. This study aimed to analyze data of patients who applied to our stroke center with an acute mild stroke clinic and received iv-tPA treatment and 3-month follow-up.
Materials and Methods: Of 350 patients receiving thrombolytic therapy, 47 (age 69.1±14.1, 28 female) patients with mild stroke were included. iv thrombolysis was initiated with a maximum delay of 4.5 h in all patients. Patients had an NIHSS score of less than 6. NIHSS scores immediately before starting thrombolytic therapy and scores 24 h after treatment were recorded. Modified rankin scale scores (mRS) at admission and at 1 and 3 months were recorded.
Results: The NIHSS scores of patients who received tPA decreased significantly after the treatment (p=0.001). The mRS scores of the patients at the first and third months were significantly decreased according to the mRS scores when they entered the treatment (p=0.001).
Conclusion: This study highlights the efficacy of iv-tPA in patients with acute ischemic stroke and mild symptoms and demonstrates the low-risk profile of this therapy.
The study protocol was approved by the Local Ethics Committee of S.B. Istanbul Medeniyet University Göztepe Prof. Dr. Suleyman Yalçin City Hospital (decision no: 2021/0108, date: 10.02.2021).
Patients provided consent to participate in the study
Externally and internally peer-reviewed.
Surgical and Medical Practices: H.H.K., R.Ş., Concept: H.H.K., R.Ş., Design: H.H.K., R.Ş., Data Collection or Processing: R.Ş., Analysis or Interpretation: H.H.K., R.Ş., Literature Search: R.Ş., Writing: H.H.K., R.Ş.
The authors have not declared any conflict of interest related to this article.
No financial support was received from any institution or person for our study.