Thrombolysis Outcomes in Acute Ischemic Stroke Patients With Prior Stroke and Diabetes Mellitus
Year: 2012
Type: article
Abstract: Mishra et al. 1 examined the influence of diabetes mellitus and prior stroke on the outcomes of patients who received thrombolysis vs nonthrombolyzed controls.They found no interaction on outcome between diabetes and prior stroke with thrombolysis treatment.These results conflict with the European Medicines Evaluation Agency's justification for restricting the use of IV alteplase.As Dr. Demaerschalk mentioned in the accompanying editorial, 2 recent studies 1,3,4 have suggested that thrombolysis can be safely used in several groups of patients who do not qualify for treatment due to strict application of exclusion criteria.In addition, most of the commonly cited thrombolytic exclusion criteria are just consensus-based, not evidence-based.2,3 It is time to reevaluate the criteria for thrombolysis, adopting a clinical score to stratify the risk, similar to those used in acute coronary syndrome.5 A good risk assessment tool will be able to identify a gradient of mortality risk by using variables that capture the majority of prognostic information to better evaluate the risk/benefit ratio for each patient.
Source: Neurology
Author: Gaetano Santulli
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2161367597