Prognostic Factors Affecting the Clinical Course and short term outcome of Acute Ischemic Stroke Patients Receiving Thrombolytic Therapy

Gomaa, Mohammed; Sayed, Sayed Sobhy; Abu El Noor, Mahmoud Ibrahim; Mohammed, Asmaa; El-Khatib, Mohamed El-Sayed

doi:10.21608/fumj.2024.279168.1340

	Prognostic Factors Affecting the Clinical Course and short term outcome of Acute Ischemic Stroke Patients Receiving Thrombolytic Therapy
Fayoum University Medical Journal
Volume 14, Issue 1, October 2024, Page 104-121 PDF (562.12 K)
Document Type: Full Length research Papers
DOI: 10.21608/fumj.2024.279168.1340
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Authors
Mohammed Gomaa ¹; Sayed Sobhy Sayed²; Mahmoud Ibrahim Abu El Noor³; Asmaa Mohammed⁴; Mohamed El-Sayed El-Khatib⁵
¹Fayoum university
²Neurology, Fayoum university, Fayoum
³Radiology department, Faculty of medicine, Fayoum University, Egypt
⁴Department of medical biochemistry,Faculty of medicine ,fayoum university
⁵Neurology
Abstract
Background: There is limited data on prognostic factors of acute ischemic stroke (AIS) treated with thrombolytic therapy.This study aimed to Illustrate the prognostic parameters of AIS individuals received intravenous recombinant tissue plasminogen activator (IV rt-PA). Method: Forty-five AIS patients eligible for receiving IV rt-PA underwent a complete neurological examination, CT brain, extra-cranial carotid duplex, stroke severity utilizing National Institutes of Health Stroke Scale (NIHSS), disability evaluation using modified Rankin Scale(mRS) 3 months post-stroke and routine lab tests. Results: Eighteen patients (40%) had unfavorable outcome (mRS ˃ 2), while 27 patients (60%) had favorable outcomes (mRS 0-2). unfavorable outcome was observed among patients with abnormal mean common carotid intima-media thickness (CIMT > 8 mm), dyslipidemia, obesity, old age, diabetes mellitus (DM) , and increased NIHSS score at admission and 24 h after IV rt-PA. while , a favorable outcome was identified in patients wit hypertension and atrial fibrillation(AF). DM, common CIMT And NIHSS at admission and 24 h following IV rt-PA were all significant independent predictors of functional outcome at three months post-stroke according to multivariable linear regression analysis with p-values < 0.05 (0.01, 0.02, 0.04, and 0.000, respectively) Conclusions: Abnormal common CIMT, DM, stroke severity, dyslipidemia, obesity, and increased patient age demonstrated a relationship with an unfavorable outcome. At the same time, AF and hypertension were correlated with a favorable outcome. NIHSS at admission and 24 h following IV rt-PA, DM, and common CIMT can be employed as independent predictors of functional outcome.
Keywords
Functional outcome; Acute ischemic stroke; carotid intima media thickness; Thrombolytic therapy


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