Comparison of Different Dosages of Alteplase in Atrial Fibrillation–Related Acute Ischemic Stroke After Intravenous Thrombolysis: A Nationwide, Multicenter, Prospective Cohort Study in Taiwan

Figures

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  Figure 1. Flow diagram of the study. ECASS indicates European Cooperative Acute Stroke Study; ICH, intracranial hemorrhage; mRS, modified Rankin Scale; NINDS, National Institute of Neurological Disorders and Stroke; SICH, symptomatic intracranial hemorrhage; SITS‐MOST, Safe Implementation of Thrombolysis in Stroke‐Monitoring Study; and TTT‐AIS, Taiwan Thrombolytic Therapy for Acute Ischemic Stroke.

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  Figure 2. Distribution of functional outcomes at 90 days. The data set shows no differences in functional outcomes between the atrial fibrillation (AF) and non‐AF groups after adjustment for the THRIVE (Totaled Health Risks in Vascular Events) score (adjusted odds ratio [OR], 1.10 [95% CI, 0.49–1.29]). mRS indicates modified Rankin Scale.

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  Figure 3. The relationship between the THRIVE (Totaled Health Risks in Vascular Events) score and clinical outcomes. AF indicates atrial fibrillation; ECASS, European Cooperative Acute Stroke Study; mRS, modified Rankin Scale; NINDS, National Institute of Neurological Disorders and Stroke; SICH, symptomatic intracranial hemorrhage; RR, relative risk; and SITS‐MOST, Safe Implementation of Thrombolysis in Stroke‐Monitoring Study.

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  Figure 4. The distribution of functional outcomes at 90 days for subgroups receiving different doses of alteplase subgroups. The data set shows no significant differences in functional outcomes between the atrial fibrillation (AF) and non‐AF groups after adjustment for the THRIVE (Totaled Health Risks in Vascular Events) score in the low‐dose subgroup (adjusted odds ratio [OR], 1.19 [95% CI, 0.98–1.43]) and standard‐dose subgroup (adjusted OR, 0.87 [95% CI, 0.65–1.18]), and no interaction was observed between different doses of alteplase (P=0.2237). mRS indicates modified Rankin Scale.

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  Figure 5. The relationship between the THRIVEs (Totaled Health Risks in Vascular Event) score and clinical outcomes for the atrial fibrillation group treated with different doses of alteplase. The zero‐inflated Poisson regression models were used to plot the relationship between the THRIVE score and symptomatic intracranial hemorrhage (SICH) by the ECASS II (European Cooperative Acute Stroke Study II) and the SITS‐MOST (Safe Implementation of Thrombolysis in Stroke‐Monitoring Study) standards. mRS indicates modified Rankin Scale; NINDS, National Institute of Neurological Disorders and Stroke; and RR, relative risk.

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  Figure 6. The distribution of each risk‐scoring system for atrial fibrillation (AF) and non‐AF groups. ECASS II indicates European Cooperative Acute Stroke Study II; GRASP, Glucose, Race, Age, Sex, Pressure, Stroke Severity; HAT, Hemorrhage After Thrombolysis; SEDAN, the Blood Sugar, Early Infarct Signs and Hyperdense Cerebral Artery Sign, Age, and National Institutes of Health Stroke Scale; SITS‐SICH, the Safe Implementation of Treatment in Stroke‐Symptomatic Intracerebral Hemorrhage; SPAN‐100, Stroke Prognostication Using Age and National Institutes of Health Stroke Scale‐100 Index; and THRIVE, Totaled Health Risks in Vascular Events.