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Soldatov M.A.
Institute of Cerebrovascular Pathology and Stroke, Federal Center for Brain and Neurotechnology of the Federal Medical and Biological Agency
Klimov L.V.
Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology
Tolmachev A.P.
Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology
Kiseleva T.V.
Scientific Research Institute of Healthcare Organization and Medical Management
Beketova E.M.
Pirogov Samara City Clinical Hospital
Belkina S.N.
Vladimirsky Moscow Regional Research Clinical Institute;
Voskresensk First Regional Hospital
Borisov D.N.
Kirov Regional Clinical Hospital
Karpov D.Yu.
City Hospital No. 5
Krasyuk M.S.
Bryansk City Hospital No. 1
Kucheryavaya M.V.
Sergiev Posad District Hospital
Minina Yu.D.
Seredavin Samara Regional Clinical Hospital
Novikov D.G.
Omsk State Medical University
Rogozhnikova N.V.
Novokuetsky Branch of the Barbarash Kemerovo Regional Clinical Cardiology Dispensary;
Novokuetsk State Institute of Advanced Medical Training — Branch of the Russian Medical Academy of Continuing Medical Education
Tabakman S.V.
Pirogov City Hospital No. 1
Telyatnik Yu.A.
Research Institute — Ochapovsky Regional Clinical Hospital No. 1
Tretyakov K.V.
Berzon Krasnoyarsk Interdistrict Clinical Hospital No. 20
Fadeeva A.S.
Vladivostok Clinical Hospital No. 1
Khan D.S.
Primorskaya Regional Clinical Hospital No. 1
Marskaya N.A.
Institute of Cerebrovascular Pathology and Stroke, Federal Center for Brain and Neurotechnology of the Federal Medical and Biological Agency
Shamalov N.A.
Pirogov National Research Medical University;
Federal Center for Brain Research and Neurotechnologies
Intravenous thrombolytic therapy of ischemic stroke with the drug Revelisa in real clinical practice: results of the IVT-AIS-R study
Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(12‑2): 42‑49
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To cite this article:
Soldatov MA, Klimov LV, Tolmachev AP, et al. . Intravenous thrombolytic therapy of ischemic stroke with the drug Revelisa in real clinical practice: results of the IVT-AIS-R study. S.S. Korsakov Journal of Neurology and Psychiatry.
2022;122(12‑2):42‑49. (In Russ.)
https://doi.org/10.17116/jnevro202212212242
Evaluation of the safety and effectiveness of thrombolytic therapy (TLT) with the drug Revelisa (alteplase) in patients with ischemic stroke (AI) in real clinical practice.
An open prospective multicenter non-interventional register study was conducted, which included 550 patients with AI — 259 (47.1%) women and 291 (52.9%) men; average age 67.7±12.6 years. All included patients underwent TLT with the drug Revelisa within 4.5 hours from the onset of the disease and, according to the protocol of reperfusion therapy of AI, clinical, instrumental and laboratory examinations were performed. Symptomatic hemorrhagic transformation (GT) was determined in accordance with the criteria of the ECASS 3 study.
The majority of patients (95.8%) suffered from hypertension, 69.6% had chronic heart failure, 53.8% had coronary heart disease, 38.7% had various cardiac arrhythmias, 20.7% of patients suffered from type 2 diabetes mellitus. A day after TLT, an improvement of 4 points or more on the NIHSS scale was noted in 45% of patients. The average dynamics index on the NIHSS stroke scale after a day was –3.2±4.7 and –4.4±6.1 per 7 females (p<0.0001). GT of the lesion of the brain developed in 10.9% of cases, symptomatic GT was diagnosed in 12 (2.3%) patients. The hospital mortality rate was 12.7%. The proportion of patients with good functional recovery (0—2 points on the modified Rankin scale (mRS)) at discharge, on days 30 and 90 was 44.7%, 59.2% and 68.5%, respectively.
Performing TLT with the drug Revelisa in patients with AI leads to a statistically significant regression of neurological symptoms. A significant proportion of patients achieve a favorable clinical outcome upon discharge from the hospital and in the long term. The obtained data on the efficacy and safety profile correlate with previously published register studies of alteplase in AI.
Keywords:
Authors:
Soldatov M.A.
Institute of Cerebrovascular Pathology and Stroke, Federal Center for Brain and Neurotechnology of the Federal Medical and Biological Agency
Klimov L.V.
Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology
Tolmachev A.P.
Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurotechnology
Kiseleva T.V.
Scientific Research Institute of Healthcare Organization and Medical Management
Beketova E.M.
Pirogov Samara City Clinical Hospital
Belkina S.N.
Vladimirsky Moscow Regional Research Clinical Institute;
Voskresensk First Regional Hospital
Borisov D.N.
Kirov Regional Clinical Hospital
Karpov D.Yu.
City Hospital No. 5
Krasyuk M.S.
Bryansk City Hospital No. 1
Kucheryavaya M.V.
Sergiev Posad District Hospital
Minina Yu.D.
Seredavin Samara Regional Clinical Hospital
Novikov D.G.
Omsk State Medical University
Rogozhnikova N.V.
Novokuetsky Branch of the Barbarash Kemerovo Regional Clinical Cardiology Dispensary;
Novokuetsk State Institute of Advanced Medical Training — Branch of the Russian Medical Academy of Continuing Medical Education
Tabakman S.V.
Pirogov City Hospital No. 1
Telyatnik Yu.A.
Research Institute — Ochapovsky Regional Clinical Hospital No. 1
Tretyakov K.V.
Berzon Krasnoyarsk Interdistrict Clinical Hospital No. 20
Fadeeva A.S.
Vladivostok Clinical Hospital No. 1
Khan D.S.
Primorskaya Regional Clinical Hospital No. 1
Marskaya N.A.
Institute of Cerebrovascular Pathology and Stroke, Federal Center for Brain and Neurotechnology of the Federal Medical and Biological Agency
Shamalov N.A.
Pirogov National Research Medical University;
Federal Center for Brain Research and Neurotechnologies
Received:
28.09.2022
Accepted:
29.09.2022
List of references:
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