Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Cardiac Myxoma: A Case Series and Pooled Analysis

doi:10.3389/fneur.2022.893807

科研成果详情

题名	Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Cardiac Myxoma: A Case Series and Pooled Analysis
作者	Rao, Jie 1,2; Tao, Zi 1; Bao, Qiongqiong3; Jiang, Mingxia 4; Zhou, Enyang 5; Cai, Xueli 2; Fu, Fangwang1
发表日期	2022-05-12
发表期刊	FRONTIERS IN NEUROLOGY 影响因子和分区
语种	英语
原始文献类型	Article
关键词	stroke myxoma intravenous thrombolysis bridging therapy alteplase efficacy
其他关键词	HEALTH-CARE PROFESSIONALS ; NEUROLOGICAL MANIFESTATIONS ; ALTEPLASE ; ANEURYSMS
摘要	Background and PurposeAcute ischemic stroke (AIS) is a major life-threatening consequence of cardiac myxoma (CM) and leads to a poor prognosis. Although intravenous thrombolysis (IVT) is the first-line treatment for AIS, its efficacy and safety in CM-AIS have not been established. Currently, there are only limited data from case reports. Our study aimed to investigate the clinical characteristics of CM-AIS and evaluate the safety and efficacy of IVT for CM-AIS patients. MethodsFourteen CM-AIS patients who received IVT between January 2016 and December 2021 were identified from our multicenter stroke registry databases. Clinical, neuroimaging and outcome data were analyzed. We then performed a pooled analysis of the published literature from inception to December 2021. ResultsOf the 14 CM-AIS patients, nine were treated with IVT alone, and five were treated with bridging therapy (BT). The median age was 51.5 years, and 57.1% were female. The median onset-to-needle time was 160 min. The median National Institute of Health Stroke Score (NIHSS) decreased from 15.5 at presentation to 13 24 h after IVT. Very early neurological improvement (VENI) was observed in one patient. Hemorrhagic transformation (HT) was observed in five (35.7%) patients, and only one patient was symptomatic (7.1%). Three-month favorable outcomes were achieved in six patients (66.7%) who underwent IVT alone and three patients (60%) who received BT, which resulted in a total proportion of favorable outcomes of 64.3%. None of the patients died at 3 months follow-up. Forty-seven cases (15 BT patients) were included for the pooled analysis. The median NIHSS score was 16.5, and VENI was observed in 10 (21.3%) patients. HT was detected in 11 patients (23.4%), and four (8.5%) patients were symptomatic. Favorable outcomes at 3 months were achieved in 61.7% of patients, 56.3% of patients who underwent IVT alone, and 73.3% of patients who received BT. The 3-month mortality rate was 4.3%. ConclusionsIVT is a potentially safe and efficient treatment for CM-AIS patients. Further studies with larger sample sizes are required to provide more evidence on the safety and efficacy of IVT and BT in CM-AIS patients.
资助项目	Public Welfare Technology Applied Research Project of Lishui City[2020SJZC055];Medical Science and Technology Project of Zhejiang Province of China[2021KY797];
出版者	FRONTIERS MEDIA SA
出版地	LAUSANNE
ISSN	1664-2295
卷号	13 页码:893807
DOI	10.3389/fneur.2022.893807
页数	12
WOS类目	Clinical Neurology ; Neurosciences
WOS研究方向	Neurosciences & Neurology
WOS记录号	WOS:000800107600001
收录类别	SCIE ; SCOPUS ; PUBMED
URL	查看原文
PubMed ID	35645949
SCOPUSEID	2-s2.0-85131157770
通讯作者地址	[Fu, Fangwang]Department of Neurology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,China ; [Cai, Xueli]Department of Neurology,The Fifth Affiliated Hospital of Wenzhou Medical University,Lishui,China
Scopus学科分类	Neurology;Neurology (clinical)
引用统计	被引频次[WOS]：0 [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/148518
专题	第二临床医学院、附属第二医院、育英儿童医院附属第二医院附属第一医院_康复科其他_附属乐清医院（乐清市人民医院）其他_附属第五医院（丽水市中心医院）
通讯作者	Cai, Xueli; Fu, Fangwang
作者单位	1.Department of Neurology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,China; 2.Department of Neurology,The Fifth Affiliated Hospital of Wenzhou Medical University,Lishui,China; 3.Department of Neurology,Affiliated Yueqing Hospital,Wenzhou Medical University,Wenzhou,China; 4.Department of Rehabilitation,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China; 5.Department of Neurology,Qingtian People's Hospital,Lishui,China
第一作者单位	第二临床医学院，附属第二医院、育英儿童医院; 附属第二医院; 附属第五医院（丽水市中心医院）
通讯作者单位	第二临床医学院，附属第二医院、育英儿童医院; 附属第二医院; 附属第五医院（丽水市中心医院）
第一作者的第一单位	第二临床医学院，附属第二医院、育英儿童医院
推荐引用方式 GB/T 7714	Rao, Jie,Tao, Zi,Bao, Qiongqiong,et al. Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Cardiac Myxoma: A Case Series and Pooled Analysis[J]. FRONTIERS IN NEUROLOGY,2022,13:893807.
APA	Rao, Jie., Tao, Zi., Bao, Qiongqiong., Jiang, Mingxia., Zhou, Enyang., ... & Fu, Fangwang. (2022). Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Cardiac Myxoma: A Case Series and Pooled Analysis. FRONTIERS IN NEUROLOGY, 13, 893807.
MLA	Rao, Jie,et al."Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Cardiac Myxoma: A Case Series and Pooled Analysis".FRONTIERS IN NEUROLOGY 13(2022):893807.