Journal article
Antithrombotic treatment of ischemic stroke among patients with occlusion or severe stenosis of the internal carotid artery: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)
Neurology, Vol.53(1), pp.122-125
1999
DOI: 10.1212/WNL.53.1.122
PMID: 10408547
Abstract
Objective:
To examine the responses to early IV administration of an anticoagulant or placebo started within 24 hours of stroke among persons with an ipsilateral occlusion or severe stenosis of the internal carotid artery (ICA) identified by carotid duplex imaging.
Background:
Patients with ischemic stroke of the cerebral hemisphere secondary to an ipsilateral occlusion or severe stenosis of the ICA generally have a poor prognosis. Early, accurate identification of these patients might permit improved treatment.
Methods:
Exploratory analysis of outcomes at 7 days and 3 months was performed among patients enrolled in the Trial of Org 10172 in Acute Stroke Treatment (TOAST) who had an ischemic stroke in the cerebral hemisphere ipsilateral to an occlusion or a stenosis >50% of the ICA identified by carotid duplex imaging.
Results:
Regardless of treatment, patients with duplex evidence of an occlusion of the ICA had more severe strokes and poorer outcomes at 7 days and 3 months than patients who had a stenosis. Favorable outcomes at 7 days were noted in 64 of 119 patients given danaparoid (53.8%) and 41 of 108 patients treated with placebo (38.0%; p = 0.023). By 3 months, favorable outcomes were noted in 82 patients given danaparoid (68.3%) and 58 patients administered placebo (53.2%; p = 0.021).
Conclusions:
Early identification by duplex imaging of an occlusion or severe stenosis of the ICA ipsilateral to a hemispheric ischemic stroke might improve selection of patients who could be treated with emergent anticoagulation. Further testing of this approach is needed.
Details
- Title: Subtitle
- Antithrombotic treatment of ischemic stroke among patients with occlusion or severe stenosis of the internal carotid artery: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)
- Creators
- H. P ADAMS - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesB. H BENDIXEN - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesE LEIRA - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesK. C CHANG - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesP. H DAVIS - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesR. F WOOLSON - Division of Biostatistics, Department of Preventive Medicine, University of Iowa College of Medicine, Iowa City, IA, United StatesW. R CLARKE - Division of Biostatistics, Department of Preventive Medicine, University of Iowa College of Medicine, Iowa City, IA, United StatesM. D HANSEN - Division of Biostatistics, Department of Preventive Medicine, University of Iowa College of Medicine, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Neurology, Vol.53(1), pp.122-125
- Publisher
- Lippincott Williams & Wilkins; Hagerstown, MD
- DOI
- 10.1212/WNL.53.1.122
- PMID
- 10408547
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Language
- English
- Date published
- 1999
- Academic Unit
- Statistics and Actuarial Science; Neurology; Epidemiology; Iowa Neuroscience Institute; Biostatistics; Neurosurgery
- Record Identifier
- 9984020705502771
Metrics
22 Record Views