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@ARTICLE{Sedghi:281516,
author = {Sedghi, Annahita and von Rennenberg, Regina and Petzold,
Gabor C and Nickenig, Georg and Kallmünzer, Bernd and
Achenbach, Stephan and Huber, Roman and Seeger, Julia and
von Sarnowski, Bettina and Thomalla, Goetz and Ringleb,
Peter Arthur and Michalski, Dominik and Laufs, Ulrich and
Royl, Georg and Szabo, Kristina and Mangner, Norman and
Puetz, Volker and Kellert, Lars and Kaeaeb, Stefan and
Wunderlich, Silke and Laugwitz, Karl-Ludwig and Petersen,
Martina and Mengel, Annerose and Leistner, David M and
Landmesser, Ulf and Endres, Matthias and Nolte, Christian H
and Siepmann, Timo},
title = {{I}ntravenous thrombolysis before percutaneous coronary
intervention in patients with non-{ST}-elevation acute
coronary syndrome and acute ischaemic stroke: a subanalysis
of the {PRAISE} study.},
journal = {Open Heart},
volume = {12},
number = {2},
issn = {2398-595X},
address = {London},
publisher = {BMJ},
reportid = {DZNE-2025-01135},
pages = {e003567},
year = {2025},
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.},
keywords = {Humans / Female / Male / Percutaneous Coronary
Intervention: adverse effects / Aged / Prospective Studies /
Acute Coronary Syndrome: therapy / Acute Coronary Syndrome:
complications / Acute Coronary Syndrome: diagnosis / Acute
Coronary Syndrome: physiopathology / Thrombolytic Therapy:
methods / Thrombolytic Therapy: adverse effects / Ischemic
Stroke: complications / Ischemic Stroke: drug therapy /
Ischemic Stroke: diagnosis / Aged, 80 and over /
Fibrinolytic Agents: administration $\&$ dosage /
Fibrinolytic Agents: adverse effects / Treatment Outcome /
Coronary Angiography / Administration, Intravenous /
Coronary Circulation / Time Factors / Acute Coronary
Syndrome (Other) / Atherosclerosis (Other) / Percutaneous
Coronary Intervention (Other) / Pharmacology, Clinical
(Other) / Stroke (Other) / Fibrinolytic Agents (NLM
Chemicals)},
cin = {AG Endres},
ddc = {610},
cid = {I:(DE-2719)1811005},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41022535},
doi = {10.1136/openhrt-2025-003567},
url = {https://pub.dzne.de/record/281516},
}