Journal Article

DZNE-2025-01135

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Intravenous thrombolysis before percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndrome and acute ischaemic stroke: a subanalysis of the PRAISE study.

Sedghi, A. ; von Rennenberg, R.Extern* ; Petzold, G. C.Extern* ; Nickenig, G. ; Kallmünzer, B. ; Achenbach, S. ; Huber, R. ; Seeger, J. ; von Sarnowski, B. ; Thomalla, G. ; Ringleb, P. A. ; Michalski, D. ; Laufs, U. ; Royl, G. ; Szabo, K. ; Mangner, N. ; Puetz, V. ; Kellert, L.Extern* ; Kaeaeb, S. ; Wunderlich, S. ; Laugwitz, K.-L. ; Petersen, M. ; Mengel, A.Extern* ; Leistner, D. M. ; Landmesser, U. ; Endres, M.DZNE* ; Nolte, C. H. ; Siepmann, T.

2025
BMJ London

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Please use a persistent id in citations: doi:10.1136/openhrt-2025-003567

Abstract: In patients with acute ischaemic stroke (AIS) and concomitant non-ST-elevation acute coronary syndrome (NSTE-ACS), the role of intravenous thrombolysis (IVT) before percutaneous coronary intervention (PCI) is unclear.We performed a subanalysis of the PRAISE (PRediction of Acute coronary syndrome in acute Ischemic StrokE) study, a multicentre, prospective observational study in 247 patients with AIS and elevated high-sensitivity cardiac troponin who underwent coronary angiography based on European Society of Cardiology guidelines. The impact of IVT prior to PCI on coronary artery flow (Thrombolysis in Myocardial Infarction (TIMI) score) and myocardial perfusion (TIMI myocardial perfusion score) was compared using Fisher's exact test and logistic regression analysis, adjusting for time from stroke onset to PCI.Among 71 patients with AIS undergoing PCI, those who received IVT prior to PCI for NSTE-ACS (33 women; median age 77 (66-82 IQR)) achieved a TIMI grade 3 flow more frequently than those undergoing direct PCI (97% vs 79%; p=0.04). Regression analysis indicated a trend toward improved coronary artery flow with IVT (adjusted OR 8.5, 95% CI 0.9 to 75.3; p=0.05). Myocardial perfusion did not differ between groups (p=0.06).This subanalysis suggests that IVT before PCI may enhance coronary artery flow in selected patients with NSTE-ACS with AIS. The results of this exploratory subanalysis warrant further investigation, particularly in patients with delayed access to PCI.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Male (MeSH) ; Percutaneous Coronary Intervention: adverse effects (MeSH) ; Aged (MeSH) ; Prospective Studies (MeSH) ; Acute Coronary Syndrome: therapy (MeSH) ; Acute Coronary Syndrome: complications (MeSH) ; Acute Coronary Syndrome: diagnosis (MeSH) ; Acute Coronary Syndrome: physiopathology (MeSH) ; Thrombolytic Therapy: methods (MeSH) ; Thrombolytic Therapy: adverse effects (MeSH) ; Ischemic Stroke: complications (MeSH) ; Ischemic Stroke: drug therapy (MeSH) ; Ischemic Stroke: diagnosis (MeSH) ; Aged, 80 and over (MeSH) ; Fibrinolytic Agents: administration & dosage (MeSH) ; Fibrinolytic Agents: adverse effects (MeSH) ; Treatment Outcome (MeSH) ; Coronary Angiography (MeSH) ; Administration, Intravenous (MeSH) ; Coronary Circulation (MeSH) ; Time Factors (MeSH) ; Acute Coronary Syndrome ; Atherosclerosis ; Percutaneous Coronary Intervention ; Pharmacology, Clinical ; Stroke ; Fibrinolytic Agents

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Contributing Institute(s):

1. Interdisciplinary Dementia Research (AG Endres)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2025

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Database coverage:
; ; ; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; DOAJ Seal ; Emerging Sources Citation Index ; Fees ; SCOPUS ; Web of Science Core Collection

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