Ischemic stroke is the most common type of stroke. Intravenous thrombolytic therapy with alteplase is currently the most effective method to improve the prognosis of patients with acute cerebral infarction. The purpose of this study was to investigate the efficacy and safety of intravenous thrombolysis with alteplase in patients with acute ischemic stroke combined with atrial fibrillation and to analyze the related influencing factors. It turns out, alteplase intravenous thrombolysis is effective for patients with ICS combined with atrial fibrillation, and the incidence of sICH are lower than those without alteplase intravenous thrombolysis, but the efficacy is worse than that of patients without atrial fibrillation. At the same time, the baseline NHISS score and systolic pressure before the thrombolytic were independent risk factors affecting the efficacy of intravenous thrombolysis with alteplase in ICS patients with atrial fibrillation. This study has provided a scientific basis for making an active decision to perform ultraearly intravenous thrombolysis in our hospital to reduce the mortality and disability rate of stroke in the region.

Ischemic stroke subtypes such as patients with large artery atherosclerosis, cardioembolism, and embolic stroke of undetermined source were investigated. This study was performed aimed to determine mean platelet volume (MPV) and mean platelet volume/platelet count (MPV/Plt) ratio in nonvalvular atrial fibrillation (AF) stroke and large artery atherosclerosis (LAA) stroke. We conducted a retrospective study of consecutive patients for treatment of acute ischemic stroke at Ruian People's Hospital from March 2017 to October 2018. The patients with ischemic stroke caused by AF and LAA were recruited to this study. Ischemic stroke was confirmed by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), ischemic lesions on diffusion-weighted imaging were measured in terms of size, composition, and pattern. MPV and platelet count were examined and (MPV/Plt) ratio was calculated. Three hundred seventy one patients were enrolled composing of 177 (47.7%) nonvalvular AF and 194 (52.2%) with LAA. The MPV (11.3 ± 1.3 vs 10.8 ± 1.0, P < .001) and MPV/Plt ratio (0.066 ± 0.025 vs 0.055 ± 0.20, P < .001) were much higher in AF group than LAA group. Receiver-operating characteristic (ROC) analysis showed MPV (AUC: 0.624, confidence interval: 0.567–0.68, P < .001) and MPV/Plt (AUC: 0.657, confidence interval: 0.601–0.713, P < .001) predicted AF between the 2 groups. MPV/Plt ratio was negatively associated with lesion volume ( r = –0.161, P = .033) in AF. The analyses of subtypes of composition of infarcts and infarct pattern showed that MPV/Plt ratio was almost higher in AF than LAA except for subcortical-only pattern. Multivariable regression analyses demonstrated National Institutes of Health Stroke Scale (NIHSS) score ( r = 2.74; P < .001), LAD ( r = –1.15; P = .025) and MPV/Plt ratio ( r = –180.64; P = .021) were correlated with lesion volume. Our results indicated elevated MPV and MPV/Plt ratio for the identification of difference between AF and LAA in patients with ischemic stroke.

Objective Ischemic stroke subtypes such as patients with large artery atherosclerosis, cardioembolism and embolic stroke of undetermined source were investigated. This study was performed aimed to determine mean platelet volume (MPV) and mean platelet volume/platelet count (MPV/Plt) Ratio in nonvalvular atrial fibrillation (AF) stroke and large artery atherosclerosis (LAA) stroke.Methods We conducted a retrospective study of consecutive patients for treatment of acute ischemic stroke at Ruian People's Hospital from March 2017 to October 2018. The patients with ischemic stroke caused by AF and LAA were recruited to this study. Ischemic stroke was confirmed by MRI and MRA, ischemic lesions on diffusion-weighted imaging were measured in terms of size, composition, and pattern. MPV and platelet count were examined and (MPV/Plt) Ratio was calculated.Results 371 patients were enrolled composing of 177 (47.7%) nonvalvular AF and 194 (52.2%) with LAA. The MPV (11.3 ± 1.3 vs. 10.8 ±1.0, p﹤0.001) and MPV/Plt ratio (0.066±0.025 vs. 0.055±0.20, p﹤0.001) were much higher in AF group than LAA group. ROC analysis showed MPV (AUC: 0.624, confidence interval:0.567-0.68,p﹤0.001) and MPV/Plt (AUC: 0.657, confidence interval:0.601-0.713,p﹤0.001) predicted AF between the two groups. MPV/Plt ratio was negatively associated with lesion volume (r = -0.161, p = 0.033) in AF. The analyses of subtypes of composition of infarcts and infarct pattern showed that MPV/Plt ratio was almost higher in AF than LAA except for subcortical-only pattern. Multivariable regression analyses demonstrated NIHSS score (r = 2.74; p﹤0.001), LAD (r = -1.15; P = 0.025) and MPV/Plt ratio (r = -180.64; P = 0.021) were correlated with lesion volume.Conclusion Our results indicated elevated MPV and MPV/Plt ratio for the identification of difference between AF and LAA in patients with ischemic stroke.