학술논문
Abstract WP14: A Patient-level Data Euclidean-matched Analysis Of Reperfusion Therapies In Acute Ischemic Stroke From The Latin American Stroke Registry (lase)
Document Type
Article
Author
Barboza, Miguel A; Torrealba-Acosta, Gabriel; Valdez, Hector; Arauz, Antonio; Abanto, Carlos; Amaya, Pablo F; Ameriso, Sebastian F; Bonardo, Pablo; Cano, Vanessa; Diaz-Escobar, Luis; Ecos, Rosa Lizbeth; Fernández Morales, Huberth; Gómez-Schneider, Maia; Gongora - Rivera, Fernando F; Huamani, Charles; Lavados, Pablo M; Marquez-Romero, Juan M; Martins, Sheila; NAVIA GONZALEZ, VICTOR HUGO; Pujol Lereis, Virginia A; Roa Wandurraga, Luis F; Ruiz-Franco, Angelica; Serrano, Fabiola; Vences, Miguel A.; Zurru, Maria; Kent, Thomas A; Mandava, Pitchaiah
Source
Stroke (Ovid); February 2023, Vol. 54 Issue: Supplement 1 pAWP14-AWP14, 1p
Subject
Language
ISSN
00392499; 15244628
Abstract
Introduction:As acute stroke therapies expand to less well-resourced regions, it is imperative to study real-world data to assess outcomes and the quality of stroke care. The present study analyzes clinical, and imaging outcomes after acute IV thrombolysis (IV-tPA) compared to mechanical thrombectomy (MT) or combined therapy in the LASE.Methods:A retrospective analysis of consecutive acute ischemic stroke cases in 17 centers from 9 Latin American (LA) countries since 2012 was performed using weighted Euclidean matching of nearest neighbors in 3-D space of baseline NIHSS, age, and glucose.Results:950 patients receiving only IV-tPA were matched to 127 treated with MT+IV-tPA. Matching resulted in 97 pairs well balanced for age (69.1 vs. 69.3), baseline NIHSS (17 vs. 17), and glucose (124.3 vs. 124.5), all p>0.2. 3-month mRS 0-1 (38.3% vs 29.8%, p=0.23) and mRS 0-2 (46.8% vs 41.5%, p=0.54) were non-significantly higher in the MT+IV-tPA group, with higher hemorrhage (26.6% vs 15.5%, p=0.05) and trends for higher death (15.1% vs 9.5%, p=0.40) and symptomatic hemorrhage (7.4% vs 6.2%, p=1.0). One hundred one patients receiving only MT were matched to 127 patients with MT+IV-tPA, resulting in 61 pairs; MT+IV-tPA showed trends for higher rates of 3-month mRS 0-1 (45.0% vs 35.6%, p=0.31), mRS 0-2 (48.3% vs 42.4%, p=0.54); with trends for lower rates of death (16.9% vs 20.0%, p=1.0) and symptomatic hemorrhage (8.3% vs 11.1%, p=0.75).Conclusions:In this real-world LA sample, trends for better functional outcomes were demonstrated with MT+IV-tPA compared to either treatment alone, as in non-LA populations. A trend for higher adverse events in the combined group requires further investigation.