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Proportion of single-chain recombinant tissue plasminogen activator and outcome after stroke.
Leys, Didier; Hommet, Yannick; Jacquet, Clémence; Moulin, Solène; Sibon, Igor; Mas, Jean-Louis; Moulin, Thierry; Giroud, Maurice; Sagnier, Sharmila; Cordonnier, Charlotte; Medeiros de Bustos, Elisabeth; Turc, Guillaume; Ronzière, Thomas; Bejot, Yannick; Detante, Olivier; Ouk, Thavarak; Mendyk, Anne-Marie; Favrole, Pascal; Zuber, Mathieu; Triquenot-Bagan, Aude; Ozkul-Wermester, Ozlem; Montoro, Francisco Macian; Lamy, Chantal; Faivre, Anthony; Lebouvier, Laurent; Potey, Camille; Poli, Mathilde; Hénon, Hilde; Renou, Pauline; Dequatre-Ponchelle, Nelly; Bodenant, Marie; Debruxelles, Sabrina; Rossi, Costanza; Bordet, Régis; Vivien, Denis.
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  • Leys D; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Hommet Y; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Jacquet C; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Moulin S; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Sibon I; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Mas JL; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Moulin T; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Giroud M; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Sagnier S; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Cordonnier C; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Medeiros de Bustos E; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Turc G; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Ronzière T; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Bejot Y; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Detante O; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Ouk T; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Mendyk AM; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Favrole P; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Zuber M; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Triquenot-Bagan A; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Ozkul-Wermester O; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Montoro FM; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Lamy C; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Faivre A; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Lebouvier L; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Potey C; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Poli M; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Hénon H; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Renou P; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Dequatre-Ponchelle N; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Bodenant M; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Debruxelles S; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Rossi C; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Bordet R; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
  • Vivien D; From Degenerative & Vascular Cognitive Disorders (D.L., C.J., S.M., C.C., T.O., A.-M.M., C.P., H.H., N.D.-P., M.B., C.R., R.B.), Department of Neurology, INSERM U 1171, CHU Lille, Universite Lille; Strokavenir Network (D.L., Y.H., C.J., S.M., I.S., J.-L.M., T.M., M.G., S.S., C.C., E.M.d.B., G.T.
Neurology ; 87(23): 2416-2426, 2016 Dec 06.
Article en En | MEDLINE | ID: mdl-27815401
ABSTRACT

OBJECTIVE:

To determine whether the ratio single chain (sc)/(sc + 2 chain [tc]) recombinant tissue plasminogen activator (rtPA) influences outcomes in patients with cerebral ischemia.

METHODS:

We prospectively included consecutive patients treated with IV rtPA for cerebral ischemia in 13 stroke centers and determined the sc/(sc + tc) ratio in the treatment administered to each patient. We evaluated the outcome with the modified Rankin Scale (mRS) at 3 months (prespecified analysis) and occurrence of epileptic seizures (post hoc analysis). We registered Outcome of Patients Treated by IV Rt-PA for Cerebral Ischaemia According to the Ratio Sc-tPA/Tc-tPA (OPHELIE) under ClinicalTrials.gov identifier no. NCT01614080.

RESULTS:

We recruited 1,004 patients (515 men, median age 75 years, median onset-to-needle time 170 minutes, median NIH Stroke Scale score 10). We found no statistical association between sc/(sc + tc) ratios and handicap (mRS > 1), dependency (mRS > 2), or death at 3 months. Patients with symptomatic intracerebral hemorrhages had lower ratios (median 69% vs 72%, adjusted p = 0.003). The sc/(sc + tc) rtPA ratio did not differ between patients with and without seizures, but patients with early seizures were more likely to have received a sc/(sc + tc) rtPA ratio >80.5% (odds ratio 3.61; 95% confidence interval 1.26-10.34).

CONCLUSIONS:

The sc/(sc + tc) rtPA ratio does not influence outcomes in patients with cerebral ischemia. The capacity of rtPA to modulate NMDA receptor signaling might be associated with early seizures, but we observed this effect only in patients with a ratio of sc/(sc + tc) rtPA >80.5% in a post hoc analysis.
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Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Terapia Trombolítica / Isquemia Encefálica / Activador de Tejido Plasminógeno / Accidente Cerebrovascular / Fibrinolíticos Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neurology Año: 2016 Tipo del documento: Article País de afiliación: Guatemala
Buscar en Google
Imprimir
XML
PubMed Links

Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Terapia Trombolítica / Isquemia Encefálica / Activador de Tejido Plasminógeno / Accidente Cerebrovascular / Fibrinolíticos Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Neurology Año: 2016 Tipo del documento: Article País de afiliación: Guatemala