Simultaneous administration of recombinant tissue plasminogen activator and edaravone in acute cerebral ischemic stroke patients.

Abstract

Among the 1052 patients admitted to our hospital because of cerebral infarction between January 1, 2007, and December 31, 2010, we report the treatment outcomes of 48 patients (4.6% of all patients) who received recombinant tissue plasminogen activator (rt-PA) therapy (simultaneously combined with edaravone) within 3 hours after the onset of infarction. Twenty (41.7%) patients started receiving edaravone before rt-PA administration, and 28 patients (58.3%) started receiving rt-PA and edaravone simultaneously. The patients had an average age of 73.5 years (range, 55-93 years; male:female, 32:16). Medical histories included hypertension, diabetes mellitus, dyslipidemia, arterial fibrillation, and a smoking history in 23 (47.8%), 7 (14.6%), 8 (16.7%), 29 (60.4%), and 8 (16.7%) of patients, respectively. Regarding the treatment outcome of the therapy, the National Institutes of Health Stroke Scale score, which was 15 points before rt-PA administration, showed a statistically significant improvement to 8 points after rt-PA administration (P < .001). The modified Rankin Scale scores at 90 days after treatment were as follows: 0 in 12 patients (25.0%), 1 in 11 patients (22.9%), 2 in 7 patients (14.6%), 3 in 5 patients (10.4%), 4 in 6 patients (12.5%), 5 in 5 patients (10.4%), and 6 in 2 patients (4.2%). The occluded blood vessel reopened completely in 30 patients (62.5%) and partially in 5 patients (10.4%). Asymptomatic hemorrhage over the entire brain developed in 2 patients (4.2%). Thus, rt-PA therapy in combination with edaravone improved the recanalization rate, reduced the incidence of intracranial hemorrhage, and improved functional prognosis.

• Authors: Katsunobu Takenaka, Masayasu Kato, Keita Yamauti, Katsuhiko Hayashi
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) 2014 Nov-Dec Vol. 23 Issue 10 Pg. 2748-2752 ISSN: 1532-8511 [Electronic] United States
• PMID: 25307430 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Chemical References

• Fibrinolytic Agents
• Free Radical Scavengers
• Tissue Plasminogen Activator
• Edaravone
• Antipyrine

Topics

• Aged
• Aged, 80 and over
• Antipyrine (administration & dosage, analogs & derivatives, therapeutic use)
• Brain Ischemia (drug therapy)
• Combined Modality Therapy
• Edaravone
• Female
• Fibrinolytic Agents (therapeutic use)
• Free Radical Scavengers (administration & dosage, therapeutic use)
• Humans
• Intracranial Hemorrhages (chemically induced, epidemiology)
• Male
• Middle Aged
• Stroke (drug therapy)
• Time Factors
• Tissue Plasminogen Activator (administration & dosage, adverse effects, therapeutic use)
• Treatment Outcome