Evidence map›Paper›PMID 32895894›Full record

ArticleTranslational stroke research2021

Iodinated Contrast Agents Reduce the Efficacy of Intravenous Recombinant Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients: a Multicenter Cohort Study.

Zhicai Chen, Chao Xu, Wansi Zhong, Xiaoxian Gong, Haitao Hu, Xuting Zhang, Yi Chen, Qingqing Li, Zhongyu Luo, Zhuojian Chen and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Translational stroke research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 39% of its field
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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. 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

11 authors at 2 institutions in 1 country.

Zhicai Chen *School of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Chao Xu *School of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Wansi ZhongSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Xiaoxian GongSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Haitao HuSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Xuting ZhangSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Yi ChenSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Qingqing LiSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Zhongyu LuoSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China.
Zhuojian ChenSchool of Management, Department of Statistics and Finance, University of Science and Technology of China, Hefei, China.
Min LouSchool of Medicine, Department of Neurology, The Second Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, China. lm99@zju.edu.cn.ORCID http://orcid.org/0000-0002-6627-064X
Second Affiliated Hospital of Zhejiang University · CNUniversity of Science and Technology of China · CN

Funding

National Key Research and Development Program of China 2016YFC1300504National Natural Science Foundation of China 81601017National Natural Science Foundation of China 81622017Science Technology Department of Zhejiang Province 2018C04011
6 · The paper itself

Abstract

This study aimed to investigate whether the application of iodinated contrast agents before intravenous (IV) recombinant tissue plasminogen activator (rt-PA) reduces the efficacy in acute ischemic stroke (AIS) patients. To determine whether the application of iodinated contrast agents before intravenous rt-PA reduces the efficacy in AIS patients. We analyzed our prospectively collected data of consecutive AIS patients receiving IV rt-PA treatment in the MISSION CHINA study. Clinical outcome at 3 months was assessed with modified Rankin Scale (mRS) score and dichotomized into good outcome (0-2) and poor outcome (3-6). Symptomatic intracerebral hemorrhage (sICH) was defined as cerebral hemorrhagic transformation in combination with clinical deterioration of National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 points at 24-h. We performed logistic regression analysis and propensity score matching analysis to investigate the impact of iodinated contrast agents before IV rt-PA on poor outcome and sICH, respectively. A total of 3593 patients were finally included, and iodinated contrast agents were used before IV rt-PA among 859 (23.9%) patients. Patients in the iodinated contrast group were more likely to result in poor outcome (39.9% vs 33.4%, P = 0.001) and sICH (3.4% vs 1.5%, P < 0.001), compared with non-contrast group. Binary logistic regression analysis revealed that the application of iodinated contrast agents was independently associated with poor outcome (OR 1.342; 95% CI 1.103-1.631; P = 0.003) and sICH (OR 1.929; 95% CI 1.153-3.230; P = 0.012), respectively. After propensity score matching, the application of iodinated contrast agents was still independently associated with poor outcome (OR 1.246; 95% CI 1.016-1.531; P = 0.034) and sICH (OR 1.965; 95% CI 1.118-3.456; P = 0.019). Applying iodinated contrast agents before IV rt-PA may reduce the thrombolytic efficacy in AIS patients. Further benefit-risk analysis might be needed when iodinated contrast-used imaging is considered before intravenous thrombolysis.

Indexed as

Brain IschemiaIschemic StrokeStrokeCohort StudiesContrast MediaFibrinolytic AgentsHumansThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeContrast MediaFibrinolytic AgentsTissue Plasminogen ActivatorAcute ischemic strokeIntravenous thrombolysisIodinated contrastRecombinant tissue-type plasminogen activator

Identifiers

PMID32895894
OpenAlexW3084329696

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.