Study Of Safety And Outcome In Transient Ischemic Attack And Minor Stroke Patients With Intravenous Thrombolysis

Objective We aimed to assess the safety and outcome of intravenous thrombolysis therapy in patients with transient ischemic attack and minor stroke.Methods1.We reviewed the medical records of 204 patients with confirmed transient ischemic attack and minor stroke(NIHSS≤3) admitted between October 2013 to June 2014 at Tianjin Huanhu Hospital and they all reached the hospital within 4.5 hours form anset.2.The baseline demographic data, and clinical, laboratory and etiology, and NIHSS of24 hours and 7 days after thrombolysis were analyzed. Patients were defined as a good short-term prognosis whose neurological deficits completely recover after thrombolysis of 24 hours and 7 days.3.Long-term clinical outcome was assessed using the modified Rankin Scale(m RS)score at 3 months and was dichotomized into favorable(m RS 0-2) versus unfavorable(m RS 3-6).Results1. The common risk factors were not significantly different between intravenous thrombolysis group(n=127) and no intravenous thrombolysis group(n=77).2. Of 127 patients with mild or improvement ischemic stroke symptoms, 68(53.5%)patients achieved recovery after 24 hours of treatment; 75(59.1%) patients achieved recovery at 7th day; and of 77 patients not receiving recombinant tissue-type plasminogen activator(rt-PA), 24(31.2%) patients and 32(41.6%) patients had recovery after 24 hours of treatment and at 7th day, there was a significant difference(p=0.002 and p=0.015).3. Of 127 patients with mild or improvement ischemic stroke symptoms, 109(85.8%)patients achieved a favorable 3-month functional outcome(m RS 0-2); and of 77 patients not receiving rt-PA, 56(72.7%) patients had a favorable 3-month functional outcome(m RS 0-2), there was a significant difference(p=0.021).4. Of 127 patients with mild or improvement ischemic stroke symptoms, 8(6.3%)patients experienced worsening of clinical symptom within 24 hours after treatment;and of 77 patients not receiving rt-PA, 13(16.9%) patients experienced worsening of clinical symptom within 24 hours after treatment, there was a significant difference(p=0.015)5.Both of groups, no symptomatic hemorrhage and no died was observed.Conclusion1. The common risk factors were not significantly different between intravenous thrombolysis group(n=127) and no intravenous thrombolysis group(n=77).2. Transient ischemic attack and minor stroke patients with intravenous thrombolysis were significantly better than the patients without intravenous thrombolysis in the short-term and long-term outcome.3. Transient ischemic attack and minor stroke patients with intravenous thrombolysis were significantly lower than the patients without intravenous thrombolysis in clinical symptoms worsening.4.There was no significant difference between transient ischemic attack and minor stroke patients with intravenous thrombolysis and the patients without intravenous thrombolysis in clinical symptoms worsening.