Idarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Thrombolytic Therapy

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dc.contributor.authorKikule, Ilga
dc.contributor.authorBaborikina, Alise
dc.contributor.authorHaritoncenko, Iveta
dc.contributor.authorKarelis, Guntis
dc.contributor.institutionDepartment of Neurology and Neurosurgery
dc.contributor.institutionDepartment of Infectology
dc.date.accessioned2022-11-07T08:40:02Z
dc.date.available2022-11-07T08:40:02Z
dc.date.issued2022-10
dc.descriptionFunding Information: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2022 by the authors.
dc.description.abstractBackground and Objectives: Thrombolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) is used to treat acute ischemic stroke. Dabigatran is a reversible thrombin inhibitor approved for stroke prevention in patients with nonvalvular atrial fibrillation. In such cases, thrombolytic therapy can be administered to certain patients after idarucizumab treatment. We evaluated the effectiveness of idarucizumab in dabigatran-treated patients receiving rt-PA. Materials and Methods: We included the data of nine idarucizumab-treated patients from the Riga East University Hospital Stroke Registry from 2018 to 2022 in our retrospective medical records analysis. We used the National Institutes of Health Stroke Scale (LV-NIHSS) score and modified Rankin scale (mRS) on admission and discharge to evaluate neurological deficit and functional outcomes. Results: We analyzed the data of nine patients (seven males and two females) with a mean age of 75.67 ± 8.59 years. The median door-to-needle time for all patients, including those who received idarucizumab before rt-PA, was 51 min (IQR = 43–133); the median LV-NIHSS score was 9 (IQR = 6.0–16.0) on admission and 4 (IQR = 2.5–4.0) at discharge; and the intrahospital mortality rate was 11.1% due to intracranial hemorrhage as a complication of rt-PA. Conclusions: Our study shows that idarucizumab as an antidote of dabigatran appears to be effective and safe in patients with acute ischemic stroke. Furthermore, the administration of idarucizumab slightly prolongs the door-to-needle time; however, the majority of cases showed clinical improvement after receiving therapy. Further randomized controlled trials should be performed to evaluate the safety and effectiveness of idarucizumab for acute ischemic stroke treatment.en
dc.description.statusPeer reviewed
dc.format.extent278852
dc.identifier.citationKikule, I, Baborikina, A, Haritoncenko, I & Karelis, G 2022, 'Idarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Thrombolytic Therapy', Medicina (Lithuania), vol. 58, no. 10, 1355. https://doi.org/10.3390/medicina58101355
dc.identifier.doi10.3390/medicina58101355
dc.identifier.issn1010-660X
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/9747
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85140604011&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofMedicina (Lithuania)
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectantidote
dc.subjectdabigatran
dc.subjectfunctional outcome
dc.subjectidarucizumab
dc.subjectintracerebral hematoma
dc.subjectischemic stroke
dc.subjectthrombolysis
dc.subjecttPA (tissue plasminogen activator)
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectGeneral Medicine
dc.titleIdarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Thrombolytic Therapyen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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