Evidence map›Paper›PMID 25213340›Full record

ArticleStroke2014

Immediate changes in stroke lesion volumes post thrombolysis predict clinical outcome.

Marie Luby, Steven J Warach, Zurab Nadareishvili, José G Merino

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

  1. Trial
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  10. [Maximal infarct volume to benefit from intravenous thrombolysis and its relation with onset to treatment time].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2017
    Article
  11. Sustained diffusion reversal with in-bore reperfusion in monkey stroke models: Confirmed by prospective magnetic resonance imaging.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2017
    Article
  12. Article
  13. Early Change in Stroke Size Performs Best in Predicting Response to Therapy.Cerebrovascular diseases (Basel, Switzerland) · 2017
    Observational
  14. Physiologic imaging in acute stroke: Patient selection.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2015
    Review
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Marie LubyFrom the Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke, Bethesda, MD (M.L., S.J.W., Z.N., J.G.M.); Department of Neurology and Neurotherapeutics, Seton/University of Texas Southwestern, Austin (S.J.W.); and Johns Hopkins Community Physicians, Bethesda, MD (Z.N., J.G.M.). lubym@ninds.nih.gov.
Steven J WarachFrom the Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke, Bethesda, MD (M.L., S.J.W., Z.N., J.G.M.); Department of Neurology and Neurotherapeutics, Seton/University of Texas Southwestern, Austin (S.J.W.); and Johns Hopkins Community Physicians, Bethesda, MD (Z.N., J.G.M.).
Zurab NadareishviliFrom the Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke, Bethesda, MD (M.L., S.J.W., Z.N., J.G.M.); Department of Neurology and Neurotherapeutics, Seton/University of Texas Southwestern, Austin (S.J.W.); and Johns Hopkins Community Physicians, Bethesda, MD (Z.N., J.G.M.).
José G MerinoFrom the Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke, Bethesda, MD (M.L., S.J.W., Z.N., J.G.M.); Department of Neurology and Neurotherapeutics, Seton/University of Texas Southwestern, Austin (S.J.W.); and Johns Hopkins Community Physicians, Bethesda, MD (Z.N., J.G.M.).

Funding

Intramural NIH HHS Z99 NS999999
6 · The paper itself

Abstract

background and purposeWe hypothesize that reversal in diffusion-weighted imaging (DWI) volume at 24 hours predicts favorable clinical outcome only if accompanied by immediate reperfusion. Our aim was to quantify the immediate DWI and mean transit time changes at 2 and 24 hours after intravenous tissue-type plasminogen activator to evaluate the effect of reperfusion and DWI change on outcome.

methodsPatients were selected from the Lesion Evolution in Stroke and Ischemia On Neuroimaging Project if they had an acute MRI with evaluable DWI and perfusion-weighted imaging, were treated with standard intravenous tissue-type plasminogen activator, had post-thrombolysis MRI with evaluable DWI and perfusion-weighted imaging at 2 and 24 hours and had follow-up fluid attenuated inversion recovery MRI at discharge through 90 days. A reader measured the DWI, mean transit time, and fluid attenuated inversion recovery volumes using a validated technique. A vascular neurologist scored the National Institutes of Health Stroke Scale at admit, 2, and 24 hours and the modified Rankin Scale at discharge, 5, 30, and 90 days. Favorable clinical outcome was defined as modified Rankin Scale of 0 or 1.

resultsSeventy-one patients met the study criteria with mean (±SD) age of 71.6 (±16.4) years, 58% women, median admit National Institutes of Health Stroke Scale 9 (interquartile range, 4-18), median onset to triage 45 minutes (30-65), and median first MRI to intravenous tissue-type plasminogen activator 47 minutes (39-59). In binary multiple logistic regression analysis, younger age (odds ratio, 1.165; P=0.014; 95% confidence interval [CI], 1.031-1.316), lower admit National Institutes of Health Stroke Scale (odds ratio, 1.221; P=0.012; 95% confidence interval, 1.045-1.427), decrease in mean transit time volume at 2 hours (odds ratio, 1.021; P=0.031; 95% confidence interval, 1.002-1.040), and decrease in DWI volume at 24 hours (odds ratio, 1.173; P=0.027; 95% confidence interval, 1.018-1.351) were significant predictors of favorable clinical outcome.

conclusionsReversal of the DWI volume at 24 hours because of immediate reperfusion in patients post thrombolysis is predictive of favorable clinical outcome.

Indexed as

Thrombolytic TherapyAgedAged, 80 and overDiffusion Magnetic Resonance ImagingFemaleFollow-Up StudiesHumansMaleMiddle AgedPredictive Value of TestsSingle-Blind MethodStrokeTime FactorsTissue Plasminogen ActivatorTreatment OutcomeTissue Plasminogen Activatorperfusion imagingthrombolytic therapy

Identifiers

PMID25213340
PMCPMC4762011

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.