Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score–Matched Follow-Up Study

Marie Louise Schmitz; Claus Z Simonsen; Heidi Hundborg; Hanne Christensen; Karsten Ellemann; Karin Geisler; Helle Klingenberg Iversen; Charlotte Madsen; Mary-Jette Rasmussen; Karsten Vestergaard; Grethe Andersen; Soeren P Johnsen

doi:10.1161/STROKEAHA.114.006570

Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score–Matched Follow-Up Study

Marie Louise Schmitz, Claus Z Simonsen, Heidi Hundborg, Hanne Christensen, Karsten Ellemann, Karin Geisler, Helle Klingenberg Iversen, Charlotte Madsen, Mary-Jette Rasmussen, Karsten Vestergaard, Grethe Andersen, Soeren P Johnsen

Department of Clinical Medicine

33 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding, in intravenous tPA-treated patients when compared with intravenous tPA eligible but nontreated patients with ischemic stroke.

METHODS: We conducted a register-based nationwide propensity score-matched follow-up study among patients with ischemic stroke in Denmark (2004-2011). Cox regression analysis was used to compute adjusted hazard ratios for all outcomes.

RESULTS: Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score-matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long-term mortality (adjusted hazard ratio, 0.66; 95% confidence interval, 0.49-0.88). The long-term risk of recurrent ischemic stroke (adjusted hazard ratio, 1.05; 95% confidence interval, 0.68-1.64) and major bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.24-1.47) did not differ significantly between the intravenous tPA-treated and nontreated patients.

CONCLUSIONS: Treatment with intravenous tPA in patients with ischemic stroke was associated with improved long-term survival.

Original language	English
Journal	Stroke
Volume	45
Issue number	10
Pages (from-to)	3070-3072
Number of pages	3
ISSN	0039-2499
DOIs	https://doi.org/10.1161/STROKEAHA.114.006570
Publication status	Published - 12 Oct 2014

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10.1161/STROKEAHA.114.006570

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Schmitz, M. L., Simonsen, C. Z., Hundborg, H., Christensen, H., Ellemann, K., Geisler, K., Iversen, H. K., Madsen, C., Rasmussen, M.-J., Vestergaard, K., Andersen, G., & Johnsen, S. P. (2014). Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score–Matched Follow-Up Study. Stroke, 45(10), 3070-3072. https://doi.org/10.1161/STROKEAHA.114.006570

Schmitz, ML, Simonsen, CZ, Hundborg, H, Christensen, H, Ellemann, K, Geisler, K, Iversen, HK, Madsen, C, Rasmussen, M-J, Vestergaard, K, Andersen, G & Johnsen, SP 2014, 'Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score–Matched Follow-Up Study', Stroke, vol. 45, no. 10, pp. 3070-3072. https://doi.org/10.1161/STROKEAHA.114.006570

@article{36c6d57adaba4d12aa9c761e628e7b29,

title = "Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score–Matched Follow-Up Study",

abstract = "BACKGROUND AND PURPOSE: Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding, in intravenous tPA-treated patients when compared with intravenous tPA eligible but nontreated patients with ischemic stroke.METHODS: We conducted a register-based nationwide propensity score-matched follow-up study among patients with ischemic stroke in Denmark (2004-2011). Cox regression analysis was used to compute adjusted hazard ratios for all outcomes.RESULTS: Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score-matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long-term mortality (adjusted hazard ratio, 0.66; 95% confidence interval, 0.49-0.88). The long-term risk of recurrent ischemic stroke (adjusted hazard ratio, 1.05; 95% confidence interval, 0.68-1.64) and major bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.24-1.47) did not differ significantly between the intravenous tPA-treated and nontreated patients.CONCLUSIONS: Treatment with intravenous tPA in patients with ischemic stroke was associated with improved long-term survival.",

author = "Schmitz, {Marie Louise} and Simonsen, {Claus Z} and Heidi Hundborg and Hanne Christensen and Karsten Ellemann and Karin Geisler and Iversen, {Helle Klingenberg} and Charlotte Madsen and Mary-Jette Rasmussen and Karsten Vestergaard and Grethe Andersen and Johnsen, {Soeren P}",

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doi = "10.1161/STROKEAHA.114.006570",

language = "English",

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pages = "3070--3072",

journal = "Stroke",

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T1 - Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis

T2 - Nationwide Propensity Score–Matched Follow-Up Study

AU - Schmitz, Marie Louise

AU - Simonsen, Claus Z

AU - Hundborg, Heidi

AU - Christensen, Hanne

AU - Ellemann, Karsten

AU - Geisler, Karin

AU - Iversen, Helle Klingenberg

AU - Madsen, Charlotte

AU - Rasmussen, Mary-Jette

AU - Vestergaard, Karsten

AU - Andersen, Grethe

AU - Johnsen, Soeren P

PY - 2014/10/12

Y1 - 2014/10/12

N2 - BACKGROUND AND PURPOSE: Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding, in intravenous tPA-treated patients when compared with intravenous tPA eligible but nontreated patients with ischemic stroke.METHODS: We conducted a register-based nationwide propensity score-matched follow-up study among patients with ischemic stroke in Denmark (2004-2011). Cox regression analysis was used to compute adjusted hazard ratios for all outcomes.RESULTS: Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score-matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long-term mortality (adjusted hazard ratio, 0.66; 95% confidence interval, 0.49-0.88). The long-term risk of recurrent ischemic stroke (adjusted hazard ratio, 1.05; 95% confidence interval, 0.68-1.64) and major bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.24-1.47) did not differ significantly between the intravenous tPA-treated and nontreated patients.CONCLUSIONS: Treatment with intravenous tPA in patients with ischemic stroke was associated with improved long-term survival.

AB - BACKGROUND AND PURPOSE: Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding, in intravenous tPA-treated patients when compared with intravenous tPA eligible but nontreated patients with ischemic stroke.METHODS: We conducted a register-based nationwide propensity score-matched follow-up study among patients with ischemic stroke in Denmark (2004-2011). Cox regression analysis was used to compute adjusted hazard ratios for all outcomes.RESULTS: Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score-matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long-term mortality (adjusted hazard ratio, 0.66; 95% confidence interval, 0.49-0.88). The long-term risk of recurrent ischemic stroke (adjusted hazard ratio, 1.05; 95% confidence interval, 0.68-1.64) and major bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.24-1.47) did not differ significantly between the intravenous tPA-treated and nontreated patients.CONCLUSIONS: Treatment with intravenous tPA in patients with ischemic stroke was associated with improved long-term survival.

U2 - 10.1161/STROKEAHA.114.006570

DO - 10.1161/STROKEAHA.114.006570

M3 - Journal article

C2 - 25190440

SN - 0039-2499

VL - 45

SP - 3070

EP - 3072

JO - Stroke

JF - Stroke

IS - 10

ER -

Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score–Matched Follow-Up Study

Abstract

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