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Effect of alteplase...
Effect of alteplase on the CT hyperdense artery sign and outcome after ischemic stroke.
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Mair, Grant (författare)
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von Kummer, Rüdiger (författare)
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Morris, Zoe (författare)
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- von Heijne, Anders (författare)
- Karolinska Institutet
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Bradey, Nick (författare)
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Cala, Lesley (författare)
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Peeters, André (författare)
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Farrall, Andrew J (författare)
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Adami, Alessandro (författare)
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Potter, Gillian (författare)
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Cohen, Geoff (författare)
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Sandercock, Peter A G (författare)
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Lindley, Richard I (författare)
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Wardlaw, Joanna M (författare)
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- Lundström, Erik, Docent, 1964- (bidragsgivare)
- Uppsala universitet,Institutionen för neurovetenskap
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(creator_code:org_t)
- 2016
- 2016
- Engelska.
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Ingår i: Neurology. - 0028-3878 .- 1526-632X. ; 86:2, s. 118-25
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: To investigate whether the location and extent of the CT hyperdense artery sign (HAS) at presentation affects response to IV alteplase in the randomized controlled Third International Stroke Trial (IST-3).METHODS: All prerandomization and follow-up (24-48 hours) CT brain scans in IST-3 were assessed for HAS presence, location, and extent by masked raters. We assessed whether HAS grew, persisted, shrank, or disappeared at follow-up, the association with 6-month functional outcome, and effect of alteplase. IST-3 is registered (ISRCTN25765518).RESULTS: HAS presence (vs absence) independently predicted poor 6-month outcome (increased Oxford Handicap Scale [OHS]) on adjusted ordinal regression analysis (odds ratio [OR] 0.66, p < 0.001). Outcome was worse in patients with more (vs less) extensive HAS (OR 0.61, p = 0.027) but not in proximal (vs distal) HAS (p = 0.420). Increasing age was associated with more HAS growth at follow-up (OR 1.01, p = 0.013). Treatment with alteplase increased HAS shrinkage/disappearance at follow-up (OR 0.77, p = 0.006). There was no significant difference in HAS shrinkage with alteplase in proximal (vs distal) or more (vs less) extensive HAS (p = 0.516 and p = 0.580, respectively). There was no interaction between presence vs absence of HAS and benefit of alteplase on 6-month OHS (p = 0.167).CONCLUSIONS: IV alteplase promotes measurable reduction in HAS regardless of HAS location or extent. Alteplase increased independence at 6 months in patients with and without HAS.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients within 6 hours of ischemic stroke with a CT hyperdense artery sign, IV alteplase reduced intra-arterial hyperdense thrombus.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
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- Av författaren/redakt...
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Mair, Grant
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von Kummer, Rüdi ...
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Morris, Zoe
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von Heijne, Ande ...
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Bradey, Nick
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Cala, Lesley
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visa fler...
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Peeters, André
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Farrall, Andrew ...
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Adami, Alessandr ...
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Potter, Gillian
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Cohen, Geoff
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Sandercock, Pete ...
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Lindley, Richard ...
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Wardlaw, Joanna ...
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Lundström, Erik, ...
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Neurologi
- Artiklar i publikationen
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Neurology
- Av lärosätet
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Uppsala universitet
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Karolinska Institutet