Red blood cell distribution width in different time-points of peripheral thrombolysis period in acute ischemic stroke is associated with prognosis
Mingli HeHongrui WangYi TangBing CuiBingchao XuXiaoqin NiuYongan SunGuanghui ZhangXiaobing HeBei WangBei XuZaipo LiYu ZhangYibo Wang
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The relationship between red blood cell distribution width (RDW) in peripheral thrombolysis period and prognosis is not fully clarified in those who underwent intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). Our study aimed to clarify this issue. A retrospective analysis of about 510 consecutive thrombolysis cases for AIS from January 2015 to March 2019 in a single-center database was done and followed-up for 3 months. We used univariate and multivariable models to evaluate the relationship between RDW levels at various time-points after IVT and the occurrence risk of hemorrhagic transformation (HT) and recurrent stroke, and used COX regression to assess the hazard ratios of outcomes with RDW levels. Elevated risk of HT was found in higher tertiles of RDW (OR = 10.282, 95% confidence interval (CI) 2.841â39.209, P < 0.001 in Tp tertile G3; OR = 5.650, 95% CI 1.992â16.025, P = 0.001 in T24 tertile G3; OR = 4.308, 95% CI 1.480â12.542, P = 0.007 in T48 tertile G3 and OR = 6.384, 95% CI 2.201â18.515, P = 0.001 in T72 tertile G3, respectively). Occurrence of recurrent stroke was highest in the RDW tertile G3 (HR = 4.580, 95% CI 2.123â9.883, P < 0.001 in Tp tertile G3; HR = 5.731, 95% CI 2.498â13.151, P = 0.001 in T24 tertile G3; HR = 3.019, 95% CI 1.969â4.059, P = 0.031 in T48 tertile G3; HR = 3.318, 95% CI 1.598â6.890, P = 0.001 in T72 tertile G3, respectively). Mean RDW levels â¥13.60 among AIS patients undergoing thrombolysis was associated with higher risk of HT and recurrent stroke.Keywords:
Stroke
Single Center
Background: COVID-19 is still present in the world, though the extent varies by region and country. According to the World Health Organization, there have been over 617 million confirmed cases of COVID-19 and over 13 million deaths worldwide since the pandemic began on March 10, 2023. Aims and Objectives: This is a study conducted with the aim of providing biomarkers to predict COVID-19 disease progression and mortality based on red cell indices and platelet indices which are commonly measured as part of a complete blood count (CBC). Materials and Methods: A prospective study was conducted during the peak of the second wave of COVID-19 from March 2021 to June 2021. The study included 540 patients who were admitted to the Government General Hospital, Nizamabad, and had tested positive for COVID-19 by RT-PCR. Red Blood Cell (RBC), Hematocrit (HCT), Red cell indices like Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Red Cell Distribution width (RDW) and Platelet indices like Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), Platelet–Large Cell Ratio were taken from CBC analyzer Sysmex XN-1000 and analyzed statistically. The patients were then followed up for a period of 14 days to track their outcomes. Results: In the data, majority were male n=334 (62%) and n=280 (38%) were female. 70.37% (n=380) were survivors and 29.63% (n=160) were non-survivors. Red blood cell, red cell indices such as RDW-CV and RDW-SD, and platelet indices such as PCT and PDW were significantly higher in non-survivors compared to survivors with P<0.05. Conclusion: Non-survivors had significantly higher levels of RDW-CV, RDW-SD, PCT, and PDW compared to survivors. These parameters in combination can be useful for predicting COVID-19 mortality at early stage in forthcoming waves.
Mean platelet volume
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Objective To study the thrombolysis of acute ischemic stroke with urokinase(UK),and to observe the clinical efficacy,looking for a safe dosage and a way fit for thrombolysis via vein Method Thrombolysis of 18 cases of acute ischemic stroke were performed with mid minidose of UK The therapy of the control group was the same as the group of thrombolysis except for not using UK Every case was scored with Europe stroke scale before and after thrombolysis and the scores were subjected to statistics to evaluat the efficacy Results The scores of ESS are higher than those before thrombolysis at the second hour,the sixth hour,the first day,the second day,the third day,the seventh day and the fourteenth day after thrombolysis The subjectives had no hemorrhage The scores of the thrombolysis group were much higher than those of control group Conclusion Compared with control group,the efficacy of thrombolysis with mid minidose is better and the side effect less [
Stroke
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To explore the effect of different starting time of thrombolysis on acute myocardial infarction (AMI).Ninety-five patients of AMI were divided into prompt thrombolysis group (less then 6 h, 46 patients) and delayed thrombolysis group (6-12 hours, 49 patients), according to the different starting time of treating AMI. The incidences of reopening and side-effect, as well as mortality were compared between two groups.The reopening rate and mortality in prompt thrombolysis group were 76% and 4%, respectively. The reopening rate and mortality in delayed thrombolysis group were 49% and 12%, respectively. Compared the prompt thrombolysis group with the delayed thrombolysis group, there was a significance discrepancy (both P<0.01). The side-effect rate had not significant discrepancy (15% vs. 16%, P>0.05).The clinical reopening rate of the thrombolysis is higher in patients with thrombolysis less than 6 hours, the mortality is lower. The thrombolytic treatment should be prompt for patients adapting thrombolysis.
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Objective To evaluate the efficiency and safety of thrombolysis with alteplase for acute cerebral infarction in the broadened therapeutic time window.Methods Ninety-nine patients with acute cerebral infarction were divided into thrombolysis group(n=52)and control group(n=47).According to the different time of thrombolysis,thrombolysis group was redivided into two subgroups,group A receiving thrombolysis in 4.5to 7.0hours after attack and group B receiving thrombolysis in 3to 4.5hours after attack.Both group A and B were treated with alteplase for thrombolysis,and control group was treated with aspirin and drugs for invigorating blood circulation and eliminating stasis.NIHSS scores before,and 1hour,1day,7days and 14 days after treatment,and modified Rankin scale(MRS)scores 90 days after thrombolysis were compared among groups,and the complications were recorded.Results Compared with before treatment,NIHSS decreased one hour after thrombolysis(P0.05)and decreased greatly 14 days after thrombolysis(P0.01)in thrombolysis group,and decreased 7and 14 days after thrombolysis in control group(P0.05).NIHSS scores were lower in thrombolysis group at all time points than those in control group(P0.05).MRS scores 90 days after thrombolysis were 1.5±0.3and 1.7±0.2in group A and B respectively,significantly lower than that in control group(2.5±0.5)(P0.05),and there was no significant difference between group A and B(P0.05).There was no significant difference in the incidence of cerebral hemorrhage between group A(2.7%)and control group(2.1%)(P0.05).Conclusions Thrombolysis with alteplase in the broadened therapeutic time window(4.5to 7.0hours)is safe and effective for acute cerebral infarction.
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Objective To investigate the dynamic change in serum matrix metalloproteinase-12(MMP-12) after thrombolysis in acute myocardial infarction(AMI) and explore its clinical significance.Methods Blood samples were collected from 60 cases of AMI before thrombolysis and 6h,24h,72h and 7d after thrombolysis.The serum MMP-12 levels of 60 cases of AMI and 18 cases of normal people(normal coronary arteriography) were measured,and at the same time,the serum MMP-12 levels of success thrombolysis group and non-success thrombolysis group were measured.Results The expression of serum MMP-12 at different periods after thrombolysis in AMI was higher than that of the normal people,and the highest level was at 72h after thrombolysis.The expression of the serum MMP-12 at 6h,24h,72h and 7d after thrombolysis in the success thrombolysis group was lower than that in the non-success thrombolysis group as if the highest level was ahead of schedule.Conclusion The expression of serum MMP-12 after thrombolysis in AMI shows dynamic change and reaches a peak at 72h after thrombolysis.The peak level of the serum MMP-12 in the success thrombolysis group seems ahead of schedule.The thrombolysis therapy has an effect on the serum MMP-12 expression.
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Objective To investigate the result of the intra-arterial thrombolysis in posterior-circulation infarction after intravenous thrombolysis.Methods 8 patients with the posterior-circulation infarction within 4-32 hours after the onset of the symptoms were assigned into a superselective intravenous thrombolysis.The symptoms were deteriorared,and they were given intra-arterial thrombolysis.To use by the U.S National of Health Stroke Scale(NIHSS) to assess the improvement of clinical symptoms.Results 5 patiens were improved obviously after intra-arterial thrombolysis.2 patients were improved slightly.1 patient had cerebral hemorrhage.Before intra-arterial thrombolysis and 24 hours,7 days after thrombolysis,the NIHSS score were(31.75±3.20),(22.25±9.22)and(16.5±9.24) score,There were significant differences between them(P0.05).Conclusion The condition of the posterior-circulation infarction was critical,if the result is poor,severe after intravenous thrombolysis,and then arterial thrombolytic therapy was given,the effects is quite satisfactory.
Stroke
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