Abstract Background and aims Ischemic stroke (IS) is a cerebrovascular disease that contributes significantly to overall population mortality and disability. One of the methods to reduce the likelihood of severe neurological deficit is the administration of thrombolytic therapy (TT) within the therapeutic window. However, reperfusion interventions, in the presence of certain risk factors and concomitant comorbidities, can be complicated by the development of hemorrhagic complications (HC). Methods The analysis was based on a combined database containing information on comorbid patients (n=2448) who underwent TT. The combined database consists of data from the Moscow Region Registry (n=2003) and the "Reperfusion in Stroke (REPIN)" registry (n=445). There were 1362 (55.6%) men and 1086 (44.4%) women. The mean patient age was 68.5 years (median = 69 years). Results A history of arterial hypertension increases the probability of HC by a factor of 1.9. The presence of congestive heart failure increases the probability of HT by a factor of 2.1. For every 1 mmol/L increase in glycemia at TT initiation above acceptable values, the risk of HC increases by a factor of 1.08. Each point indicating increased stroke severity on the NIHSS scale is associated with an increase in the risk of hemorrhagic complications by a factor of 1.09. Concomitant endovascular intervention performed alongside thrombolysis increases the risk of hemorrhagic complications in the postoperative period by a factor of 3.3. Conclusions Active identification of comorbid patients and careful monitoring of clinical status with the determination of individual risk factors contributes to reducing the risk of hemorrhagic complications following reperfusion interventions. Conflict of interest No
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Egor Nikulin
European Stroke Journal
First Pavlov State Medical University of St. Petersburg
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Egor Nikulin (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7f86bfa21ec5bbf080e4 — DOI: https://doi.org/10.1093/esj/aakag023.1560