Defining Clinically Relevant Cerebral Hemorrhage After Thrombolytic Therapy for Stroke
Therapies Thursday, August 7th, 2014STROKEAHA: August 5, 2014
Analysis of the National Institute of Neurological Disorders and Stroke Tissue-Type Plasminogen Activator Trials
Background and Purpose—Several definitions have been proposed to distinguish clinically relevant from incidental cerebral hemorrhagic transformation after thrombolytic therapy for acute ischemic stroke. We investigated which definition best identifies cerebral hemorrhages that alter long-term functional outcome in the National Institute of Neurological Disorders and Stroke (NINDS) tissue-type plasminogen activator (tPA) trials.
Methods—We analyzed 4 candidate hemorrhage definitions for which the NINDS tPA trials public data set had relevant data. For each, we identified tPA-treated patients having that hemorrhage type and compared their actual functional outcomes at 90 days with their predicted outcomes had they not received tPA and not had the hemorrhage. Projected outcomes without tPA were based on a 17-variable prognostic model derived from the NINDS tPA trials placebo group. Read More
