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000281516 0247_ $$2doi$$a10.1136/openhrt-2025-003567
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000281516 037__ $$aDZNE-2025-01135
000281516 041__ $$aEnglish
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000281516 1001_ $$aSedghi, Annahita$$b0
000281516 245__ $$aIntravenous thrombolysis before percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndrome and acute ischaemic stroke: a subanalysis of the PRAISE study.
000281516 260__ $$aLondon$$bBMJ$$c2025
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000281516 520__ $$aIn patients with acute ischaemic stroke (AIS) and concomitant non-ST-elevation acute coronary syndrome (NSTE-ACS), the role of intravenous thrombolysis (IVT) before percutaneous coronary intervention (PCI) is unclear.We performed a subanalysis of the PRAISE (PRediction of Acute coronary syndrome in acute Ischemic StrokE) study, a multicentre, prospective observational study in 247 patients with AIS and elevated high-sensitivity cardiac troponin who underwent coronary angiography based on European Society of Cardiology guidelines. The impact of IVT prior to PCI on coronary artery flow (Thrombolysis in Myocardial Infarction (TIMI) score) and myocardial perfusion (TIMI myocardial perfusion score) was compared using Fisher's exact test and logistic regression analysis, adjusting for time from stroke onset to PCI.Among 71 patients with AIS undergoing PCI, those who received IVT prior to PCI for NSTE-ACS (33 women; median age 77 (66-82 IQR)) achieved a TIMI grade 3 flow more frequently than those undergoing direct PCI (97% vs 79%; p=0.04). Regression analysis indicated a trend toward improved coronary artery flow with IVT (adjusted OR 8.5, 95% CI 0.9 to 75.3; p=0.05). Myocardial perfusion did not differ between groups (p=0.06).This subanalysis suggests that IVT before PCI may enhance coronary artery flow in selected patients with NSTE-ACS with AIS. The results of this exploratory subanalysis warrant further investigation, particularly in patients with delayed access to PCI.
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000281516 650_7 $$2Other$$aAcute Coronary Syndrome
000281516 650_7 $$2Other$$aAtherosclerosis
000281516 650_7 $$2Other$$aPercutaneous Coronary Intervention
000281516 650_7 $$2Other$$aPharmacology, Clinical
000281516 650_7 $$2Other$$aStroke
000281516 650_7 $$2NLM Chemicals$$aFibrinolytic Agents
000281516 650_2 $$2MeSH$$aHumans
000281516 650_2 $$2MeSH$$aFemale
000281516 650_2 $$2MeSH$$aMale
000281516 650_2 $$2MeSH$$aPercutaneous Coronary Intervention: adverse effects
000281516 650_2 $$2MeSH$$aAged
000281516 650_2 $$2MeSH$$aProspective Studies
000281516 650_2 $$2MeSH$$aAcute Coronary Syndrome: therapy
000281516 650_2 $$2MeSH$$aAcute Coronary Syndrome: complications
000281516 650_2 $$2MeSH$$aAcute Coronary Syndrome: diagnosis
000281516 650_2 $$2MeSH$$aAcute Coronary Syndrome: physiopathology
000281516 650_2 $$2MeSH$$aThrombolytic Therapy: methods
000281516 650_2 $$2MeSH$$aThrombolytic Therapy: adverse effects
000281516 650_2 $$2MeSH$$aIschemic Stroke: complications
000281516 650_2 $$2MeSH$$aIschemic Stroke: drug therapy
000281516 650_2 $$2MeSH$$aIschemic Stroke: diagnosis
000281516 650_2 $$2MeSH$$aAged, 80 and over
000281516 650_2 $$2MeSH$$aFibrinolytic Agents: administration & dosage
000281516 650_2 $$2MeSH$$aFibrinolytic Agents: adverse effects
000281516 650_2 $$2MeSH$$aTreatment Outcome
000281516 650_2 $$2MeSH$$aCoronary Angiography
000281516 650_2 $$2MeSH$$aAdministration, Intravenous
000281516 650_2 $$2MeSH$$aCoronary Circulation
000281516 650_2 $$2MeSH$$aTime Factors
000281516 7001_ $$0P:(DE-2719)9001452$$avon Rennenberg, Regina$$b1$$udzne
000281516 7001_ $$0P:(DE-2719)2810273$$aPetzold, Gabor C$$b2$$udzne
000281516 7001_ $$aNickenig, Georg$$b3
000281516 7001_ $$aKallmünzer, Bernd$$b4
000281516 7001_ $$aAchenbach, Stephan$$b5
000281516 7001_ $$aHuber, Roman$$b6
000281516 7001_ $$aSeeger, Julia$$b7
000281516 7001_ $$avon Sarnowski, Bettina$$b8
000281516 7001_ $$aThomalla, Goetz$$b9
000281516 7001_ $$aRingleb, Peter Arthur$$b10
000281516 7001_ $$aMichalski, Dominik$$b11
000281516 7001_ $$aLaufs, Ulrich$$b12
000281516 7001_ $$aRoyl, Georg$$b13
000281516 7001_ $$aSzabo, Kristina$$b14
000281516 7001_ $$aMangner, Norman$$b15
000281516 7001_ $$aPuetz, Volker$$b16
000281516 7001_ $$0P:(DE-2719)9003034$$aKellert, Lars$$b17$$udzne
000281516 7001_ $$aKaeaeb, Stefan$$b18
000281516 7001_ $$aWunderlich, Silke$$b19
000281516 7001_ $$aLaugwitz, Karl-Ludwig$$b20
000281516 7001_ $$aPetersen, Martina$$b21
000281516 7001_ $$0P:(DE-2719)9003061$$aMengel, Annerose$$b22$$udzne
000281516 7001_ $$aLeistner, David M$$b23
000281516 7001_ $$aLandmesser, Ulf$$b24
000281516 7001_ $$0P:(DE-2719)2811033$$aEndres, Matthias$$b25$$udzne
000281516 7001_ $$aNolte, Christian H$$b26
000281516 7001_ $$00000-0003-2196-5904$$aSiepmann, Timo$$b27
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