Evaluation of the Therapeutic Outcomes of Tissue Plasminogen Activator and Antiplatelet Therapy in Patients with Ischemic Stroke

Background and Aim: Stroke is one of the most common causes of disability and mortality worldwide, with ischemic stroke accounting for the majority of cases. Timely treatment with thrombolytic agents like alteplase and antiplatelet drugs such as aspirin can improve clinical outcomes. This study aimed to compare the therapeutic outcomes of alteplase and aspirin in patients with ischemic stroke. Materials and Methods: This analytical cross-sectional and prospective cohort study was conducted at Shahid Beheshti Hospital in Kashan in ۲۰۲۳. Patients were divided into two groups based on the time of hospital arrival and NIHSS scores: the alteplase group (treatment within ۳ hours of symptom onset) and the aspirin group (treatment after ۱۲ hours). Demographic, clinical, and laboratory variables, as well as treatment outcomes (NIHSS and MRS scores), were compared at ۷۲ hours and ۹۰ days post-treatment. Data were analyzed using SPSS version ۲۲ and appropriate statistical tests. Results: The mean age of patients was ۵۹.۳ ± ۸.۲۲ years in the alteplase group and ۵۷.۷ ± ۶.۶ years in the aspirin group. Significant improvement in NIHSS and MRS scores was observed in both groups, but the alteplase group showed greater improvement at both ۷۲ hours and ۹۰ days post-treatment (P=۰.۰۰۱). Mortality rates did not differ significantly between the groups, but adverse effects such as intracranial hemorrhage were more frequent in the alteplase group. Conclusion: Treatment with alteplase compared to aspirin can lead to significant improvement in clinical outcomes for ischemic stroke patients, particularly when administered within the ۳- to ۴.۵-hour window after symptom onset. However, careful management of adverse effects, such as intracranial hemorrhage, is essential. Increasing public awareness about the importance of timely hospital admission can enhance the efficacy of thrombolytic therapies.

کلیدواژه ها:

Ischemic stroke ، CVA ، Alteplase ، Aspirin ، NIHSS ، MRS ، Thrombolytic therapy