The systematic analysis of idarucizumab administration prior to intravenous thrombolysis in acute stroke patients in Russian Federation
- Authors: Domashenko M.A.1, Loskutnikov M.A.1
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Affiliations:
- Magnitogorsk Iron & Steel Clinical Hospital
- Issue: Vol 22, No 9 (2020)
- Pages: 52-56
- Section: Articles
- URL: https://bakhtiniada.ru/2075-1753/article/view/95361
- DOI: https://doi.org/10.26442/20751753.2020.9.200474
- ID: 95361
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Abstract
Background. Direct oral anticoagulants are preferentially used for the prevention of stroke compared to warfarin for non-valvular atrial fibrillation because of their favorable risk-benefit profile. Approximately 1-2% of patients with non-valvular atrial fibrillation taking direct oral anticoagulants are expected to develop acute ischemic stroke (AIS). Thrombolytic treatment with i.v. recombinant tissue plasminogen activator (rtPA) is limited in such patients. Idarucizumab is a specific antagonist of dabigatran which completely reverses its anticoagulant activity within a few minutes and is reported to be used in the context of i.v. thrombolysis in AIS. Materials and methods. We performed the systematic review of all available clinical data of 9 cases of rtPA treatment following the administration of idarucizumab in Russian Federation starting from November 2019 until October 2020. Results. The median age of 9 patients (55.6% males) was 71 [59; 75] years. The median NIHSS score at admission was 15 [10; 16]; the median NIHSS score on day 10-14 after rtPA treatment 3 [2; 4]. A half of patients was modified Rankin scale (mRS) 2 and a half was mRS 3 on day 10-14 after the stroke. Brain infarction on CT developed in 7 patients 24 hours after trPA treatment, in 1 case there were no ischemic lesion on CT. Hemorrhagic transformation (HT) developed in 5 cases, 3 patients had no HT on CT scan. Conclusion. Idaricuzumab administration prior to rtPA thrombolysis appeared to be safe and feasible in AIS patients in comprehensive stroke units in Russian Federation.
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##article.viewOnOriginalSite##About the authors
Maksim A. Domashenko
Magnitogorsk Iron & Steel Clinical Hospital
Email: mdomashenko@gmail.com
канд. мед. наук, невролог, глав. врач Magnitogorsk, Russia
Mark A. Loskutnikov
Magnitogorsk Iron & Steel Clinical Hospitalканд. мед. наук, невролог, рук. регионального сосудистого центра Magnitogorsk, Russia
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