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10.1161/STROKEAHA.116.014096 http://scihub22266oqcxt.onion/10.1161/STROKEAHA.116.014096 C4995119!4995119!27491738     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27491738&cmd=llinks): Failed to open stream: HTTP request failed! 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Leukoaraiosis, cerebral hemorrhage and outcome after IV thrombolysis for acute ischemic stroke: A meta-analysis (v1) |pdf=|usr=}}{{27491738}} gab.com Text Leukoaraiosis, cerebral hemorrhage and outcome after IV thrombolysis for acute ischemic stroke: A meta-analysis (v1) JO: Stroke http://www.kidney.de/pget.php?&tw=1&pmid=27491738 #FOAvip Background-and-Purpose: We performed a meta-analysis to assess whether leukoaraiosis on brain CT scans of acute ischemic stroke patients treated with intravenous (IV) thrombolysis is associated with an increased risk of symptomatic intracerebral hemorrhage (sICH) and/or poor functional outcome at 3?6 months post-stroke. Methods: We searched PubMed and pooled relevant data in meta-analyses using random effects models. Using odds ratios (OR), we quantified the strength of association between the presence and severity of leukoaraiosis and post-thrombolysis sICH or 3?6 month modified Rankin Score (mRS) >2. Results: Eleven eligible studies (n=7194) were pooled in meta-analysis. The risk of sICH was higher in patients with leukoaraiosis (OR: 1.55; 95%CI: 1.17?2.06, p=0.002) and severe leukoaraiosis (OR: 2.53; 95%CI: 1.92?3.34, p<0.0001), compared to patients without leukoaraiosis. Leukoaraiosis was an independent predictor of sICH in six included studies (n=4976, adjusted-OR: 1.75, 95%CI: 1.35?2.27; p<0.0001). OR for leukoaraiosis and poor 3?6 month outcome was 2.02 (95%CI: 1.54?2.65, p<0.0001), with significant statistical heterogeneity (I2:75.7%, p=0.002). In adjusted analysed, leukoaraiosis was an independent predictor of poor outcome (n=3688, adjusted-OR: 1.61, 95%CI: 1.44?1.79; p<0.0001). In post-hoc analyses, including only leukoaraiosis patients in RCTs (IST-3, NINDS, ECASS-1-2; n=2234), tPA vs. control was associated with higher sICH risk (OR: 5.50; 95%CI: 2.49?12.13), but lower poor outcome risk (OR: 0.75; 95%CI: 0.60?0.95). Conclusions: Leukoaraiosis might increase post-IV thrombolysis sICH risk and poor outcome post-stroke. Despite increased sICH risk, IV tPA treatment has net clinical benefit in patients with leukoaraiosis. Given the risk of bias/confounding, these results should be considered hypothesis-generating and do not justify withholding IV thrombolysis. Twit Text FOAVip Leukoaraiosis, cerebral hemorrhage and outcome after IV thrombolysis for acute ischemic stroke: A meta-analysis (v1) ????Stroke http://www.kidney.de/pget.php?&tw=1&pmid=27491738 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27491738 #FOAvip English Wikipedia <ref>{{Cite pmid|27491738}}</ref> Leukoaraiosis, cerebral hemorrhage and outcome after IV thrombolysis for acute ischemic stroke: A meta-analysis (v1) #MMPMID27491738 Charidimou A; Pasi M; Fiorelli M; Shams S; von Kummer R; Pantoni L; Rost N Stroke 2016[Sep]; 47 (9): 2364-72 PMID27491738show ga Background-and-Purpose: We performed a meta-analysis to assess whether leukoaraiosis on brain CT scans of acute ischemic stroke patients treated with intravenous (IV) thrombolysis is associated with an increased risk of symptomatic intracerebral hemorrhage (sICH) and/or poor functional outcome at 3?6 months post-stroke. Methods: We searched PubMed and pooled relevant data in meta-analyses using random effects models. Using odds ratios (OR), we quantified the strength of association between the presence and severity of leukoaraiosis and post-thrombolysis sICH or 3?6 month modified Rankin Score (mRS) >2. Results: Eleven eligible studies (n=7194) were pooled in meta-analysis. The risk of sICH was higher in patients with leukoaraiosis (OR: 1.55; 95%CI: 1.17?2.06, p=0.002) and severe leukoaraiosis (OR: 2.53; 95%CI: 1.92?3.34, p<0.0001), compared to patients without leukoaraiosis. Leukoaraiosis was an independent predictor of sICH in six included studies (n=4976, adjusted-OR: 1.75, 95%CI: 1.35?2.27; p<0.0001). OR for leukoaraiosis and poor 3?6 month outcome was 2.02 (95%CI: 1.54?2.65, p<0.0001), with significant statistical heterogeneity (I2:75.7%, p=0.002). In adjusted analysed, leukoaraiosis was an independent predictor of poor outcome (n=3688, adjusted-OR: 1.61, 95%CI: 1.44?1.79; p<0.0001). In post-hoc analyses, including only leukoaraiosis patients in RCTs (IST-3, NINDS, ECASS-1-2; n=2234), tPA vs. control was associated with higher sICH risk (OR: 5.50; 95%CI: 2.49?12.13), but lower poor outcome risk (OR: 0.75; 95%CI: 0.60?0.95). Conclusions: Leukoaraiosis might increase post-IV thrombolysis sICH risk and poor outcome post-stroke. Despite increased sICH risk, IV tPA treatment has net clinical benefit in patients with leukoaraiosis. Given the risk of bias/confounding, these results should be considered hypothesis-generating and do not justify withholding IV thrombolysis. äLeukoaraiosis, cerebral hemorrhage and outcome after IV thrombolysis f(epmc).pdf DeepDyve Pubget Overpricing