Safety of intravenous thrombolysis in stroke of unknown time of onset: A systematic review and meta-analysis

Wang, Chen; Wang, Wanting; Ji, Jianling; Wang, Jian; Zhang, Ruijun; Wang, Yujie

doi:10.1007/s11239-021-02476-6

Cited by 4 publications

(2 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[ 40 ] Recent study pointed that overproduction of ROS induced endothelial dysfunction from micro vessel under condition of high glucose. [ 41,42 ] Consistent with the transcriptome sequencing analysis, the mRNA expression of Nox2 and Nox4 determined by RT‐PCR was significantly increased in RIA from the HS group, which might result in abnormal ROS levels in RIA in HS offspring. As a natural compound, apocynin has been widely used as a Nox inhibitor in animal models of ROS‐related diseases, for cardiovascular, metabolic, liver, and neurodegenerative diseases.…”

Section: Discussionmentioning

confidence: 56%

Prenatal High‐Sucrose Diet Induced Vascular Dysfunction of Renal Interlobar Arteries in the Offspring via PPARγ‐RXRg‐ROS/Akt Signaling

Feng,

Liu,

Wang

et al. 2024

Molecular Nutrition Food Res

View full text Add to dashboard Cite

ScopePrenatal nutrition imbalance correlates with developmental origin of cardiovascular diseases; however whether maternal high‐sucrose diet (HS) during pregnancy causes vascular damage in renal interlobar arteries (RIA) from offspring still keeps unclear.Methods and resultsPregnant rats are fed with normal drinking water or 20% high‐sucrose solution during the whole gestational period. Swollen mitochondria and distributed myofilaments are observed in vascular smooth muscle cells of RIA exposed to prenatal HS. Maternal HS increases phenylephrine (PE)‐induced vasoconstriction in the RIA from adult offspring. NG‐Nitro‐l‐arginine (L‐Name) causes obvious vascular tension in response to PE in offspring from control group, not in HS. RNA‐Seq of RIA is performed to reveal that the gene retinoid X receptor g (RXRg) is significantly decreased in the HS group, which could affect vascular function via interacting with PPARγ pathway. By preincubation of RIA with apocynin (NADPH inhibitor) or capivasertib (Akt inhibitor), the results indicate that ROS and Akt are the vital important factors to affect the vascular function of RIA exposure to prenatal HS.ConclusionMaternal HS during the pregnancy increases PE‐mediated vasoconstriction of RIA from adult offspring, which is mainly related to the enhanced Akt and ROS regulated by the weakened PPARγ‐RXRg.

show abstract

Section: Discussionmentioning

confidence: 56%

Prenatal High‐Sucrose Diet Induced Vascular Dysfunction of Renal Interlobar Arteries in the Offspring via PPARγ‐RXRg‐ROS/Akt Signaling

Feng,

Liu,

Wang

et al. 2024

Molecular Nutrition Food Res

View full text Add to dashboard Cite

show abstract

“…En los casos de un evento cerebrovascular de tiempo de inicio desconocido un reciente metanálisis realizado por Wang C, et al (2021), mostró que los ictus agudos, pueden tratarse de forma segura con alteplasa y mostró resultados funcionales beneficiosos (9).…”

Section: Discussionunclassified

Fibrinólisis intravenosa con alteplasa en un paciente joven con ictus isquémico agudo asociado a coartación de aorta

Acosta

Aguirre²,

Flores³

et al. 2022

MedicienciasUTA

View full text Add to dashboard Cite

Respecto a la coartación de aorta, es una enfermedad congénita rara, en la que, se produce una arteriopatía sistémica, ocasionada por estrechamiento del vaso, generando obstrucción al flujo aórtico, , ésta malformacion, es muy poco relacionada con el ictus isquemico agudo en los jovenes, por lo que, se plantea como objetivo presentar el caso de un paciente masculino de 26 años de edad con cuadro clinico compatible con accidente cerebrovascular isquémico secundario a coartación de la aorta en la evaluación con angiotac de torax y ecocardiograma, ingresa en periodo de ventana ( 4.5 horas) y se realiza la trombolisis farmacologica con regimen acelerado con alteplasa. Se realiza revision bibliografia de articulos cientificos actuales, estudios , meta analisis y guias de la New York Heart Asociation y de la American Stroke Association , artículos en su mayoría del año 2020 en adelante, obtenidos de bases de datos reconocidas a nivel internacional como PUBMED, JAMA, ELSEVIER, en un total de 21 artículos en los idiomas inglés y español, concluyéndose que, la coexistencia de ictus isquémico agudo asociado a coartación de aorta es una rara ocurrencia en la población joven y que puede ser tratada inicialmente con infusión intravenosa de alteplasa como método de trombólisis y que existen otras alternativas terapéuticas para corrección de coartación de aorta.

show abstract

Software with artificial intelligence-derived algorithms for analysing CT brain scans in people with a suspected acute stroke: a systematic review and cost-effectiveness analysis

Westwood,

Ramaekers,

Grimm

et al. 2024

Health Technol Assess

View full text Add to dashboard Cite

Background Artificial intelligence-derived software technologies have been developed that are intended to facilitate the review of computed tomography brain scans in patients with suspected stroke. Objectives To evaluate the clinical and cost-effectiveness of using artificial intelligence-derived software to support review of computed tomography brain scans in acute stroke in the National Health Service setting. Methods Twenty-five databases were searched to July 2021. The review process included measures to minimise error and bias. Results were summarised by research question, artificial intelligence-derived software technology and study type. The health economic analysis focused on the addition of artificial intelligence-derived software-assisted review of computed tomography angiography brain scans for guiding mechanical thrombectomy treatment decisions for people with an ischaemic stroke. The de novo model (developed in R Shiny, R Foundation for Statistical Computing, Vienna, Austria) consisted of a decision tree (short-term) and a state transition model (long-term) to calculate the mean expected costs and quality-adjusted life-years for people with ischaemic stroke and suspected large-vessel occlusion comparing artificial intelligence-derived software-assisted review to usual care. Results A total of 22 studies (30 publications) were included in the review; 18/22 studies concerned artificial intelligence-derived software for the interpretation of computed tomography angiography to detect large-vessel occlusion. No study evaluated an artificial intelligence-derived software technology used as specified in the inclusion criteria for this assessment. For artificial intelligence-derived software technology alone, sensitivity and specificity estimates for proximal anterior circulation large-vessel occlusion were 95.4% (95% confidence interval 92.7% to 97.1%) and 79.4% (95% confidence interval 75.8% to 82.6%) for Rapid (iSchemaView, Menlo Park, CA, USA) computed tomography angiography, 91.2% (95% confidence interval 77.0% to 97.0%) and 85.0 (95% confidence interval 64.0% to 94.8%) for Viz LVO (Viz.ai, Inc., San Fransisco, VA, USA) large-vessel occlusion, 83.8% (95% confidence interval 77.3% to 88.7%) and 95.7% (95% confidence interval 91.0% to 98.0%) for Brainomix (Brainomix Ltd, Oxford, UK) e-computed tomography angiography and 98.1% (95% confidence interval 94.5% to 99.3%) and 98.2% (95% confidence interval 95.5% to 99.3%) for Avicenna CINA (Avicenna AI, La Ciotat, France) large-vessel occlusion, based on one study each. These studies were not considered appropriate to inform cost-effectiveness modelling but formed the basis by which the accuracy of artificial intelligence plus human reader could be elicited by expert opinion. Probabilistic analyses based on the expert elicitation to inform the sensitivity of the diagnostic pathway indicated that the addition of artificial intelligence to detect large-vessel occlusion is potentially more effective (quality-adjusted life-year gain of 0.003), more costly (increased costs of £8.61) and cost-effective for willingness-to-pay thresholds of £3380 per quality-adjusted life-year and higher. Limitations and conclusions The available evidence is not suitable to determine the clinical effectiveness of using artificial intelligence-derived software to support the review of computed tomography brain scans in acute stroke. The economic analyses did not provide evidence to prefer the artificial intelligence-derived software strategy over current clinical practice. However, results indicated that if the addition of artificial intelligence-derived software-assisted review for guiding mechanical thrombectomy treatment decisions increased the sensitivity of the diagnostic pathway (i.e. reduced the proportion of undetected large-vessel occlusions), this may be considered cost-effective. Future work Large, preferably multicentre, studies are needed (for all artificial intelligence-derived software technologies) that evaluate these technologies as they would be implemented in clinical practice. Study registration This study is registered as PROSPERO CRD42021269609. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR133836) and is published in full in Health Technology Assessment; Vol. 28, No. 11. See the NIHR Funding and Awards website for further award information.

show abstract

Safety of intravenous thrombolysis in stroke of unknown time of onset: A systematic review and meta-analysis

Cited by 4 publications

References 53 publications

Prenatal High‐Sucrose Diet Induced Vascular Dysfunction of Renal Interlobar Arteries in the Offspring via PPARγ‐RXRg‐ROS/Akt Signaling

Prenatal High‐Sucrose Diet Induced Vascular Dysfunction of Renal Interlobar Arteries in the Offspring via PPARγ‐RXRg‐ROS/Akt Signaling

Fibrinólisis intravenosa con alteplasa en un paciente joven con ictus isquémico agudo asociado a coartación de aorta

Software with artificial intelligence-derived algorithms for analysing CT brain scans in people with a suspected acute stroke: a systematic review and cost-effectiveness analysis

Contact Info

Product

Resources

About