Assessing Reperfusion and Recanalization as Markers of Clinical Outcomes After Intravenous Thrombolysis in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET)

被引：120

作者：

De Silva, Deidre A.

Fink, John N. ^{[2
]}

Christensen, Soren

Ebinger, Martin

Bladin, Christopher ^{[3
]}

Levi, Christopher R. ^{[4
]}

Parsons, Mark ^{[4
]}

Butcher, Ken ^{[5
]}

Barber, P. Alan ^{[6
]}

Donnan, Geoffrey A. ^{[7
,8
]}

Davis, Stephen M. ^{[1
,8
]}

机构：

[1] Royal Melbourne Hosp, Div Neurosci, Parkville, Vic 3050, Australia

[2] Christchurch Sch Med & Hlth Sci, Canterbury, New Zealand

[3] Eastern Melbourne Neurosci, Melbourne, Vic, Australia

[4] John Hunter Hosp, New Lambton Hts, NSW, Australia

[5] Univ Alberta, Edmonton, AB T6G 2M7, Canada

[6] Auckland City Hosp, Auckland, New Zealand

[7] Natl Stroke Res Inst, Melbourne, Vic, Australia

[8] Univ Melbourne, Melbourne, Vic 3010, Australia

来源：

STROKE | 2009年 / 40卷 / 08期

基金：

英国医学研究理事会;

关键词：

clinical outcomes; ischemic stroke; recanalization; reperfusion; thrombolysis; STROKE;

D O I：

10.1161/STROKEAHA.108.543595

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-Reperfusion and recanalization have both been used as surrogate markers of clinical outcome in trials of stroke thrombolysis. We aimed to prove that the beneficial impact of recanalization with intravenous tissue plasminogen activator on clinical outcomes is attributable to reperfusion in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET). Methods-EPITHET was a prospective, randomized, placebo-controlled trial of intravenous tissue plasminogen activator in the 3- to 6-hour window. Reperfusion was defined as >90% reduction in magnetic resonance perfusion-weighted imaging lesion volume and recanalization as improvement of MR angiographic Thrombolysis In Myocardial Infarction grading by >= 2 points from baseline to Day 3 to 5. Results-At Day 3 to 5, reperfusion and recanalization with intravenous tissue plasminogen activator were strongly correlated. Reperfusion was associated with improved clinical outcome independent of whether recanalization occurred. In contrast, recanalization was not associated with clinical outcome when reperfusion was included as a covariate in regression analyses. Conclusion-Reperfusion is a surrogate marker of clinical outcomes independent of recanalization based on the criteria applied in EPITHET. The impact of recanalization on clinical outcomes was attributable to reperfusion. (Stroke. 2009; 40: 2872-2874.)

引用

页码：2872 / 2874

页数：3

共 8 条

[1] Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study [J].