Objective: Recombinant tissue plasminogen activator (rt-PA, alteplase), as the primary thrombolytic agent, has been proved effective and beneficial in patients with acute ischemic stroke (AIS). This study aimed to predict the three months outcome of AIS patients who received thrombolytic therapy regarding mortality, symptomatic intracerebral hemorrhage (sICH) and functional outcome in comparison to non thrombolyzed patients.
Patients and methods: This study included 80 patients with AIS who attended Zagazig University Hospital (ZUH) during the period from Feb 2016 to Feb 2018. Patients were divided into two groups; Group I included 40 AIS patients who received rt-PA within 4.5 hours from symptom onset. Group II included 40 AIS patients (as a control group) who received regular treatment, rather than rt-PA within the first 24 hours from symptom onset, they were selected to match group I as regard baseline data. Stroke severity was assessed by National Institute of Health Stroke Scale (NIHSS). Modified Rankin Scale (mRS) was used to measure 3 months functional outcome.
Result: After 3 months follow–up, death rate was slightly higher among group I (7.5%) compared to group II (5%). 7.5 % of group I patients had sICH compared to 5% of group II patients, this difference was not statistically significant. More patients in group I had favorable outcome (mRS=0-2) than group II (65% vs. 60%, OR1.38, 95% CI 0.50-3.6, P 0.51).
Conclusion: After 3 months follow up, rt-PA was more frequently associated with favorable outcome; however, it increased the risk of sICH and death compared to controls.