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dc.contributor.authorVilas, D.
dc.contributor.authorGomis Cortina, Meritxell
dc.contributor.authorBlanco, Miguel
dc.contributor.authorCortés Martínez, Jordi
dc.contributor.authorMillán Torné, Mònica
dc.contributor.authorDe La Ossa, Natalia Pérez
dc.contributor.authorDorado, Laura
dc.contributor.authorLópez Cancio, Elena
dc.contributor.authorSuñol, A.
dc.contributor.authorDávalos Errando, Antoni
dc.contributor.otherUniversitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa
dc.date.accessioned2023-04-21T09:01:30Z
dc.date.available2023-04-21T09:01:30Z
dc.date.issued2012
dc.identifier.citationVilas, D. [et al.]. Circadian rhythms in the efficacy of intravenous alteplase in patients with acute ischemic stroke and middle cerebral artery occlusion. "Chronobiology international", 2012, vol. 29, núm. 10, p. 1383-1389.
dc.identifier.issn0742-0528
dc.identifier.urihttp://hdl.handle.net/2117/386509
dc.description.abstractCircadian rhythm interactions of hemostatic factors can modify tissue plasminogen activator (tPA) effects. We assess the relationship of the time frame of intravenous tPA administration with the outcome of patients with acute ischemic stroke (AIS). We studied 135 consecutive patients with AIS and transcranial duplex documented middle cerebral artery (MCA) occlusion treated with intravenous tPA. Complete recanalization was defined as total improvement on thrombolysis in brain ischemia (TIBI) grades 2 h after tPA infusion. Clinical response was evaluated by the modified Rankin scale at 90 days. We determined plasminogen activator inhibitor-1 (PAI-1) levels in 33 patients with available plasma samples before treatment. Our results are follows: 92 (68.1%) patients were treated in the diurnal (9:00–21:00) and 43 (31.8%) in the nocturnal period (21:00–9:00). Complete recanalization was recorded in 52/135 (38.5%) patients. Both the rate of complete recanalization (45.6% vs. 23.2%; p = .01) and good clinical outcome (64.1% vs. 44.2%; p = .02) were significantly higher in the group of diurnal tPA administration compared with those treated in the nocturnal period. The adjusted odds ratio (OR) of diurnal tPA treatment for complete MCA recanalization was 2.37 (95% confidence interval [CI], 1.02–5.52; p = .045). Diurnal tPA infusion significantly improved the overall distribution of scores on the modified Rankin scale, as compared with nocturnal treatment (OR, 2.07; 95% CI, 1.16–4.64 by ordinal regression analysis). Low PAI-1 levels were associated with complete recanalization but did not significantly differ between the two time frames. In conclusion, diurnal administration of tPA is associated with complete MCA recanalization and better functional outcome at 90 days in patients with AIS.
dc.format.extent7 p.
dc.language.isoeng
dc.rightsAtribución-NoComercial-SinDerivadas 4.0 Internacional
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subjectÀrees temàtiques de la UPC::Matemàtiques i estadística::Estadística matemàtica::Anàlisi multivariant
dc.subjectÀrees temàtiques de la UPC::Matemàtiques i estadística::Matemàtica aplicada a les ciències
dc.subject.lcshMultivariate analysis
dc.subject.lcshBiology
dc.subject.otherAcute stroke
dc.subject.otherCircadian rhythms
dc.subject.otherStroke
dc.subject.otherThrombolysis
dc.subject.othertP
dc.titleCircadian rhythms in the efficacy of intravenous alteplase in patients with acute ischemic stroke and middle cerebral artery occlusion
dc.typeArticle
dc.subject.lemacAnàlisi multivariable
dc.subject.lemacBiologia
dc.identifier.doi10.3109/07420528.2012.728655
dc.description.peerreviewedPeer Reviewed
dc.subject.amsClassificació AMS::62 Statistics::62H Multivariate analysis
dc.subject.amsClassificació AMS::92 Biology and other natural sciences::92C Physiological, cellular and medical topics
dc.relation.publisherversionhttps://www.tandfonline.com/doi/full/10.3109/07420528.2012.728655
dc.rights.accessOpen Access
local.identifier.drac11211721
dc.description.versionPostprint (author's final draft)
local.citation.authorVilas, D.; Gomis, M.; Blanco, M.; Cortes, J.; Millán, M.; De La Ossa, N.; Dorado, L.; López Cancio, E.; Suñol, A.; Dávalos, A.
local.citation.publicationNameChronobiology international
local.citation.volume29
local.citation.number10
local.citation.startingPage1383
local.citation.endingPage1389


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