American Journal of Psychiatry and Neuroscience

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Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke

Received: 12 June 2018    Accepted: 02 July 2018    Published: 30 July 2018
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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.

DOI 10.11648/j.ajpn.20180602.14
Published in American Journal of Psychiatry and Neuroscience (Volume 6, Issue 2, June 2018)
Page(s) 51-55
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Urokinase, Ozagrel, Acute Ischemic Stroke, Effective, Safety

References
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[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.
Author Information
  • Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China

  • Division of Neurology, National University Hospital, Singapore

  • Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China

  • Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China

  • Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China

  • Department of Neurology, Guigang City People’s Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, China

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    Yuan Nong, Bernard Poon-Lap CHAN, Xingyue Qin, Chong Wei, Kui Chen, et al. (2018). Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke. American Journal of Psychiatry and Neuroscience, 6(2), 51-55. https://doi.org/10.11648/j.ajpn.20180602.14

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    ACS Style

    Yuan Nong; Bernard Poon-Lap CHAN; Xingyue Qin; Chong Wei; Kui Chen, et al. Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke. Am. J. Psychiatry Neurosci. 2018, 6(2), 51-55. doi: 10.11648/j.ajpn.20180602.14

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    AMA Style

    Yuan Nong, Bernard Poon-Lap CHAN, Xingyue Qin, Chong Wei, Kui Chen, et al. Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke. Am J Psychiatry Neurosci. 2018;6(2):51-55. doi: 10.11648/j.ajpn.20180602.14

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  • @article{10.11648/j.ajpn.20180602.14,
      author = {Yuan Nong and Bernard Poon-Lap CHAN and Xingyue Qin and Chong Wei and Kui Chen and Hai Xiao},
      title = {Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke},
      journal = {American Journal of Psychiatry and Neuroscience},
      volume = {6},
      number = {2},
      pages = {51-55},
      doi = {10.11648/j.ajpn.20180602.14},
      url = {https://doi.org/10.11648/j.ajpn.20180602.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajpn.20180602.14},
      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.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Efficacy and Safety of Intravenous Urokinase and Sodium Ozagrel in Acute Ischemic Stroke
    AU  - Yuan Nong
    AU  - Bernard Poon-Lap CHAN
    AU  - Xingyue Qin
    AU  - Chong Wei
    AU  - Kui Chen
    AU  - Hai Xiao
    Y1  - 2018/07/30
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    DO  - 10.11648/j.ajpn.20180602.14
    T2  - American Journal of Psychiatry and Neuroscience
    JF  - American Journal of Psychiatry and Neuroscience
    JO  - American Journal of Psychiatry and Neuroscience
    SP  - 51
    EP  - 55
    PB  - Science Publishing Group
    SN  - 2330-426X
    UR  - https://doi.org/10.11648/j.ajpn.20180602.14
    AB  - 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.
    VL  - 6
    IS  - 2
    ER  - 

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