Renal Dysfunction and In-Hospital Outcomes in Patients With Acute Ischemic Stroke After Intravenous Thrombolytic Therapy.

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Rao, Zhen-Zhen

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Gu, Hong-Qiu

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Wang, Xian-Wei

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Xie, Xue-Wei

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Yang, Xin

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Wang, Chun-Juan

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Zhao, Xingquan

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Xian, Ying

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Wang, Yi-Long

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Li, Zi-Xiao

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Xiao, Rui-Ping

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Wang, Yong-Jun

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Chinese Stroke Center Alliance investigators

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2020-12-14T18:51:48Z

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2020-12-14T18:51:48Z

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2019-10-09

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2020-12-14T18:51:45Z

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Background The impact of estimated glomerular filtration rate (eGFR) on clinical short-term outcomes after stroke thrombolysis with tissue plasminogen activator remains controversial. Methods and Results We analyzed 18 320 ischemic stroke patients who received intravenous tissue plasminogen activator at participating hospitals in the Chinese Stroke Center Alliance between June 2015 and November 2017. Multivariate logistic regression models were used to evaluate associations between eGFR (<45, 45-59, 60-89, and ≥90 mL/min per 1.73 m2) and in-hospital mortality and symptomatic intracerebral hemorrhage, adjusting for patient and hospital characteristics and the hospital clustering effect. Of the 18 320 patients receiving tissue plasminogen activator, 601 (3.3%) had an eGFR <45, 625 (3.4%) had an eGFR 45 to 59, 3679 (20.1%) had an eGFR 60 to 89, and 13 415 (73.2%) had an eGFR ≥90. As compared with eGFR ≥90, eGFR values <45 (6.7% versus 0.9%, adjusted odds ratio, 3.59; 95% CI, 2.18-5.91), 45 to 59 (4.0% versus 0.9%, adjusted odds ratio, 2.00; 95% CI, 1.18-3.38), and 60 to 89 (2.5% versus 0.9%, adjusted odds ratio, 1.67; 95% CI, 1.20-2.34) were independently associated with increased odds of in-hospital mortality. However, there was no statistically significant association between eGFR and symptomatic intracerebral hemorrhage. Conclusions eGFR was associated with an increased risk of in-hospital mortality in acute ischemic stroke patients after treatment with tissue plasminogen activator. eGFR is an important predictor of poststroke short-term death but not of symptomatic intracerebral hemorrhage.

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2047-9980

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2047-9980

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https://hdl.handle.net/10161/21897

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eng

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Ovid Technologies (Wolters Kluwer Health)

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Journal of the American Heart Association

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10.1161/jaha.119.012052

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Chinese Stroke Center Alliance investigators

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Humans

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Brain Ischemia

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Kidney Diseases

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Acute Disease

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Tissue Plasminogen Activator

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Glomerular Filtration Rate

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Treatment Outcome

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Thrombolytic Therapy

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Infusions, Intravenous

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Registries

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Hospital Mortality

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Survival Rate

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Retrospective Studies

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Dose-Response Relationship, Drug

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Aged

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Aged, 80 and over

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Middle Aged

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China

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Female

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Male

dc.title

Renal Dysfunction and In-Hospital Outcomes in Patients With Acute Ischemic Stroke After Intravenous Thrombolytic Therapy.

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Journal article

duke.contributor.orcid

Xian, Ying|0000-0002-1237-1162

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e012052

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20

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School of Medicine

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Duke Clinical Research Institute

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Neurology, Neurocritical Care

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Medicine, Clinical Pharmacology

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Duke

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Institutes and Centers

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Neurology

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Clinical Science Departments

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Medicine

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Published

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8

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