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Clinical features and efficacy of reperfusion therapy in minor ischemic stroke patients with atrial fibrillation

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Abstract

The efficacy of reperfusion therapy (RT) using intravenous infusion of recombinant tissue plasminogen activator and/or endovascular therapy for minor ischemic stroke (MIS) has not yet been established. The present study aimed to elucidate the clinical features of MIS patients with atrial fibrillation (AF) and examine whether they could be potential candidates for RT. Data of MIS patients, defined as those with a score ≤ 5 on the National Institute of Health Stroke Scale, were extracted from patients admitted to our hospital between 2006 and 2018, and clinical characteristics were compared between the AF and non-AF groups. Thereafter, the impact of RT on outcomes in the AF- group was evaluated using the modified Rankin scale (mRS) score 3 months after onset and compared to that of standard medical therapy (SMT) using propensity score matching (PSM). Of 10,483 stroke patients, 3003 were shortlisted, and 457 AF patients and 2546 non-AF patients were finally selected. Patients in the AF group had more RT (13.3% vs. 5.7%, p < 0.001) than those in the non-AF group. Using PSM, 53 patients each were extracted from the AF-RT and AF-SMT groups. The frequencies of mRS = 0 or 1 for the AF-RT and AF-SMT groups were 69.8% and 64.2% (p = 0.536), respectively, with a significant difference in mRS = 0 (56.5% vs. 34.0%, p = 0.019). The present study found that MIS patients with AF underwent more RT than those without AF and that RT compared favorably with SMT for them; further study is warranted to examine whether these patients could be good candidates for RT.

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Correspondence to Eiichi Nomura.

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All the authors declared that they have no conflict of interest.

Ethics approval: The study protocol was approved by our institutional review board.

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Nomura, E., Takemaru, M., Himeno, T. et al. Clinical features and efficacy of reperfusion therapy in minor ischemic stroke patients with atrial fibrillation. J Thromb Thrombolysis (2020). https://doi.org/10.1007/s11239-020-02057-z

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Keywords

  • Atrial fibrillation
  • Endovascular therapy
  • Minor ischemic stroke
  • Reperfusion therapy
  • Tissue-type plasminogen activator