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11.01.2024 | Original Communication

Thrombolysis in Stroke-Heart Syndrome: a useful tool for neurocardiac wellness?

verfasst von: Ilario Scali, Marcello Naccarato, Gabriele Prandin, Federica Palacino, Carlo Lugnan, Laura Mancinelli, Emanuele Vincis, Giovanni Furlanis, Paola Caruso, Paolo Manganotti

Erschienen in: Journal of Neurology | Ausgabe 5/2024

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Abstract

Introduction

Stroke-heart syndrome is a physiopathological condition of cardiac suffering due to cerebral injury secondary to major vessel occlusion in anterior circulation. It can be detected by increase in cardiac blood biomarkers. Our aim was to investigate a possible ancillary effect of thrombolysis in mitigating Stroke-Heart Syndrome after acute ischaemic stroke.

Patients and methods

We retrospectively collected ischaemic stroke patients admitted to our Stroke Unit between August 1, 2017 and December 31, 2020 and acutely treated for an intracranial anterior circulation occlusion, without anamnestic ischaemic cardiopathy. We divided patients into Group B (“Bridge”) including patients treated with both thrombolysis and thrombectomy and Group D (“Direct”) including primary thrombectomies.

Results

120 patients were included in the study. Group B consisted of 92 patients, Group D of 28 patients, without significant differences in age, baseline and discharge NIHSS, cardiovascular risk factors or TOAST aetiology. Whilst admission, troponin levels were similar in both groups, significant differences in troponin peak (median 16 ng/L in Group B vs 45 ng/L in Group D, p = 0.022) and BNP values (median 455 pg/mL in Group B vs 784 pg/mL in Group D, p = 0.031) were found in the first 72 h since admission. Functional independence at discharge was significantly higher in Group B than Group D (mRS 0–2 36% vs 10%, p = 0.011).

Discussion and conclusion

Significant differences in troponin peak and BNP values suggest a reduced stroke-related heart impairment in patients treated with bridge therapeutic approach: thrombolysis prior to thrombectomy could have a complementary effect on reducing Stroke-Heart Syndrome, improving overall neurological outcome.

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Titel: Thrombolysis in Stroke-Heart Syndrome: a useful tool for neurocardiac wellness?
verfasst von: Ilario Scali
Marcello Naccarato
Gabriele Prandin
Federica Palacino
Carlo Lugnan
Laura Mancinelli
Emanuele Vincis
Giovanni Furlanis
Paola Caruso
Paolo Manganotti
Publikationsdatum: 11.01.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 5/2024
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-12167-2

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Introduction

Patients and methods

Results

Discussion and conclusion

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