Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke
American Journal of Psychiatry and Neuroscience
Volume 6, Issue 2, June 2018, Pages: 51-55
Received: Jun. 12, 2018; Accepted: Jul. 2, 2018; Published: Jul. 30, 2018
Views 923      Downloads 51
Authors
Yuan Nong, Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China
Bernard Poon-Lap CHAN, Division of Neurology, National University Hospital, Singapore
Xingyue Qin, Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China
Chong Wei, Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China
Kui Chen, Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China
Hai Xiao, Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China
Article Tools
Follow on us
Abstract
Urokinase and sodium ozagrel are widely used in patients with acute ischemic stroke (AIS) in China. But the effectiveness and safety of the two combinations are not yet clear. A total of 129 AIS patients who were treated with combined intravenous (IV) urokinase and sodium ozagrel within 6 hours of onset were included in this study. All the patients were assessed with the National Institute of Health Stroke Scale (NIHSS) score at baseline, 6 hours, at hospital discharge, and 1 month after AIS. All the patients were characterized into two groups based on early response (decrease in NIHSS score≥4 points at 6 hours) and good outcome (NIHSS score ≤ 1 at 1 month), and assessed treatment safety by evaluating intracranial hemorrhage and mortality. There were 54 patients in the good outcome group and 74 in the bad outcome group at the end. Multivariate analysis showed that shorter onset to treatment time, a lower baseline NIHSS score, and lack of large artery stenosis or occlusion werel associated with good outcome at 1 month. This study suggested that combined IV urokinase and sodium ozagrel therapy was effective and safe in treating patient with AIS within a 6-hour time window. With lower cost and a longer time window, it can be used as an alternative intravenous thrombolytic therapy in patients with AIS except rt-PA.
Keywords
Urokinase, Ozagrel, Acute Ischemic Stroke, Effective, Safety
To cite this article
Yuan Nong, Bernard Poon-Lap CHAN, Xingyue Qin, Chong Wei, Kui Chen, Hai Xiao, Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke, American Journal of Psychiatry and Neuroscience. Vol. 6, No. 2, 2018, pp. 51-55. doi: 10.11648/j.ajpn.20180602.14
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995; 333: 1581–1587.
[2]
Tomsick TA. Intravenous thrombolysis for acute ischemic stroke. J Vasc Interv Radiol. 2004; 15: S67-76.
[3]
Cronin CA. Intravenous tissue plasminogen activator for stroke: a review of the ECASS III results in relation to prior clinical trials. J Emerg Med. 2010; 38: 99-105.
[4]
Hatcher MA, Starr JA. Role of tissue plasminogen activator in acute ischemic stroke. Ann Pharmacother. 2011; 45: 364-371.
[5]
Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008; 359: 1317-1329.
[6]
Ahmed N, Wahlgren N, Grond M, et al. Implementation and outcome of thrombolysis with alteplase 3–4.5 hours after an acute stroke: an updated analysis from SITS-ISTR. Lancet Neurol 2010; 9: 866–874.
[7]
Shobha N, Buchan AM, Hill MD, et al. Thrombolysis at 3-4.5 hours after acute ischemic stroke onset--evidence from the Canadian Alteplase for Stroke Effectiveness Study (CASES) registry. Cerebrovasc Dis. 2011; 31: 223-228
[8]
Ghandehari K. Barriers of thrombolysis therapy in developing countries. Stroke Res Tre. 2011; 2011: 686797. doi: 10. 4061/2011/686797. Epub 2011 Mar 17.
[9]
Wang Y, Wu D, Zhao X, et al. Hospital resource for urokinase/ recombinant tissue-type plasminogen activator therapy for acute stroke in Beijing. Surg Neurol 2009; 72 (Suppl. I): 2-7.
[10]
Xu ZP, Li HH, Li YH, et al. Feasibility and outcomes of intravenous thrombolysis 3-4.5 hours after stroke in Chinese patients. J Clin Neurosci. 2014; 21: 822-826.
[11]
Sadeghi-Hokmabadi E, Farhoudi M, Taheraghdam A, et al. Intravenous recombinant tissue plasminogen activator for acute ischemic stroke: a feasibility and safety study. Int J Gen Med 2016; 9: 361-367.
[12]
Sharma VK, Tsivgoulis G, Tan JH, et al. Feasibility and safety of intravenous thrombolysis in multiethnic Asian stroke patients in Singapore. J Stroke Cerebrovasc Dis. 2010; 19: 424-430.
[13]
Simon JE, Sandler DL, Pexman JHW, HillMD, Buchan AM: Is intravenous recombinant tissue plasminogen activator (rt-PA) safe for use in patients over 80 years old withacute ischaemic stroke? – the Calgary expe-rience. Age Ageing 2004; 33: 143-149.
[14]
Zeevi N, Chhabra J, Silverman IE, et al. Acute stroke management in the elderly. Cerebrovasc Dis. 2007: 23: 304-308.
[15]
Chen Y, Li CH, Wang YX, et al. Safety and effectiveness of intravenous thrombolysis with recombinant tissue plasminogen activator in eighty years and older acute ischemic stroke patients. Eur Rev Med Pharmacol Sci. 2015; 19: 1852-1858.
[16]
Reuter B, Gumbinger C, Sauer T. et al. Intravenous thrombolysis for acute ischaemic stroke in the elderly: data from the Baden-Wuerttemberg stroke registry. Eur J Neurol. 2016; 23: 13-20.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186