To investigate the factors associated with early neurological improvement of intravenous recombinant tissue plasminogen activator (rt-PA) treatment to acute ischemic stroke (AIS) within 4.5 hours of onset.
Demographics onset to treatment time, risk factors, and clinical and laboratory data of 209 AIS patients undergoing intravenous rt-PA therapy at the Second Affiliated Hospital, Zhejiang University School of Medicine between January 2013 and August 2016 were retrospectively analyzed. The National Institute of Health Stroke Scale (NIHSS) score was recorded before thrombolytic therapy, 24 h after the treatment and 7 d after the treatment to evaluate the recovery of neurological function. A multivariate logistic regression analysis was performed to assess the outcomes.
Of the 209 AIS patients treated by intravenous thrombolysis with rt-PA. Low-density lipoprotein (LDL) levels were significantly lower (P < 0.05) in patients with early neurological improvement. The multivariable analysis showed that non-atrial fibrillation (AF) was independently associated with early neurological improvement at 24 h and 7 d after thrombolysis. Onset to treatment time was an independent predictor (P < 0.05) for early neurological improvement at 7 d after thrombolysis. The NIHSS score and diastolic blood pressure on admission were associated with symptomatic intracerebral hemorrhagic (sICH) transformation.
Non-AF was independently associated with early neurological improvement after intravenous thrombolysis in AIS patients, but non-AF was not associated with the occurrence of sICH. Onset to treatment time was an independent predictor of early neurological improvement at 7 d after thrombolysis in AIS patients.