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OUT COME OF ACUTE ISCHEMIC STROKE PATIENTS TREATED WITH INTRAVENOUS RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR IN COASTAL ANDHRA PRADESH, INDIA

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Abstract title OUT COME OF ACUTE ISCHEMIC STROKE PATIENTS TREATED WITH INTRAVENOUS RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR IN COASTAL ANDHRA PRADESH, INDIA S. Kumaravelu1, M. Chekuri2, S.S. Buddha3, R.B. Pothineni4. 1Dr Ramesh Cardiac & Multispeciality Hospitals Pvt Ltd, Neurology, Guntur, India. 2Dr. Ramesh Cardiac & Multispeciality Hospitals Pvt Ltd, Neurology, Vijayawada, India. 3Dr Ramesh Cardiac & Multispeciality Hospitals Pvt Ltd, Neurology, Vijayawada, India. 4Dr Ramesh Cardiac & Multispeciality Hospitals Pvt Ltd, Cardiology, Vijayawada, India. Background and Aims Thrombolysis with intravenous (IV) tissue plasminogen activator(rtPA) decreases disability in acute ischemic stroke (AIS) when given within 4.5 hours. This study analysed outcomes of thrombolysed patients with rtPA(Actilyse) in coastal Andhra Pradesh, india where data is sparse. Method In this retrospective hospital based observational study, consecutive thrombolysed patients of AIS were studied over 4 years. Statistical analysis system(SAS) was used to analyse data on demography, assessment NIHSS score, comorbidities, onset to needle time (ONT) and outcome at 1,3and 6 months. Outcome was stratified as good (mRS 0-2) and bad (mRS 3-6). Results Eighty one patients were analysed. There were 59 males and 22 females with mean ages 58.23 and 66.59 years respectively. Sixty three patients improved (79%). NIHSSscore correlated well with outcome (95% CI 0.9999, p=0.0001). No univariate correlation existed with age, sex, ischemic heart disease, stroke, hypertension, Diabetes Mellitus(DM), atrial fibrillation, smoking, alcohol, hyperlipedemia and ONT. Multivariate correlation of age and NIHSSscore showed significance in the middle aged (CI 0.9987, p=0.0026) as was ONT with NIHSS in the 3 to 4.5 hours group (CI 1.000, p <0.0001)and hypertension with NIHSS (CI 0.9966, p=0.0069). Hypertension alone had better outcome than with stroke and DM (CI 0.998, p=0.0004). ASPECTS correlated positively with outcome (p= 0.0114) as was MRI volume on diffusion weighted imaging (CI 0.998, p=0.0004). Conclusion AIS patients improve with thrombolysis at all ages especially middle age. NIHSS score with/without hypertension or ONT correlate with outcome. Hypertension alone had better outcome than with stroke and DM. ASPECTS and MRI volume correlate with outcome.

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