Abstract T P63: Low Creatinine Level Is Associated With Very Early Neurological Improvement After Thrombolysis for Ischemic Stroke
Introduction: Early neurological improvement (ENI) within 24 hours after fibrinolysis for ischemic stroke is strongly associated with recanalization and favourable outcome at 3 months. However, it remains unknown why some patients recover within the 1st hour after treatment (very ENI, VENI) whereas others have ENI later within 24 hours. We therefore assessed which factors were associated with timing of ENI.
Methods: We retrospectively studied consecutive patients treated with intravenous rt-PA for ischemic stroke within 4h30 after onset in 4 regional hospitals. VENI assessed at 1h and ENI assessed at 24h post-treatment was defined by NIHSS improvement by 40% from baseline. We compared patients with VENI to patients with ENI.
Results: Among 421 patients (mean age 70.8±15.2 years, median NIHSS 15, median onset-to-treatment time 170 minutes) 65 (15%) had VENI, and 110 (26%) ENI. Patients with VENI had significantly lower serum creatinine level than patients with ENI (79±19 vs. 91±35 μmol/L; p=0.01). After adjustment for age, sex, baseline NIHSS, High Blood Pressure and glucose level at admission, patients with low creatinine level were more likely to have VENI (lowest tertile, OR=3.8 CI95%=[1.5-9.7], intermediate tertile, OR=1.8 CI95%=[0.8-4.3]; p for trend=0.006). VENI patients were as likely as ENI patients to have a modified Rankin scale ≤ 2 at 3 months (88% vs. 84%, p=0.46).
Conclusion: Low serum creatinine levels are associated with VENI, suggesting that quickness of efficacy of rt-PA, of reperfusion, or of neurological recovery may depend on renal function.
Author Disclosures: S. Guettier: None. M. Apol: None. A. Bonnet: None. J. Cohez: None. T. Tchoumi: None. L. Dubuc: None. J. Arzur: None. V. de la Sayette: None. E. Touzé: None.
- © 2015 by American Heart Association, Inc.