2026-04-14T05:01:50Zhttps://recercat.cat/oai/request

oai:recercat.cat:10256/195462024-06-18T12:41:27Zcom_2072_452955com_2072_2054col_2072_453079

00925njm 22002777a 4500 dc Jensen, M. author Boutitie, Florent author Cheng, Bastian author Cho, T.H. author Ebinger, Martin author Endres, Matthias author Fiebach, Jochen B. author Fiehler, Jens author Ford, Ian author Galinovic, Ivana author Königsberg, Alina author Puig Alcántara, Josep author Roy, P. author Wouters, A. author Thijs, Vincent author Lemmens, Robin author Muir, Keith W. author Nighoghossian, Norbert author Pedraza, S. author Simonsen, Claus Z. author Gerloff, Christian author Thomalla, Götz author 2021-02 Polypharmacy is an important challenge in clinical practice. Our aim was to determine the effect of polypharmacy on functional outcome and treatment effect of alteplase in acute ischaemic stroke. Methods This was a post hoc analysis of the randomized, placebo‐controlled WAKE‐UP trial of magnetic resonance imaging guided intravenous alteplase in unknown onset stroke. Polypharmacy was defined as an intake of five or more medications at baseline. Comorbidities were assessed by the Charlson Comorbidity Index (CCI). The primary efficacy variable was favourable outcome defined by a score of 0–1 on the modified Rankin Scale at 90 days. Logistic regression analysis was used to test for an association of polypharmacy with functional outcome, and for interaction of polypharmacy and the effect of thrombolysis. Results Polypharmacy was present in 133/503 (26%) patients. Patients with polypharmacy were older (mean age 70 vs. 64 years; p < 0.0001) and had a higher score on the National Institutes of Health Stroke Scale at baseline (median 7 vs. 5; p = 0.0007). A comorbidity load defined by a CCI score ≥ 2 was more frequent in patients with polypharmacy (48% vs. 8%; p < 0.001). Polypharmacy was associated with lower odds of favourable outcome (adjusted odds ratio 0.50, 95% confidence interval 0.30–0.85; p = 0.0099), whilst the CCI score was not. Treatment with alteplase was associated with higher odds of favourable outcome in both groups, with no heterogeneity of treatment effect (test for interaction of treatment and polypharmacy, p = 0.29). Conclusion In stroke patients, polypharmacy is associated with worse functional outcome after intravenous thrombolysis independent of comorbidities. However, polypharmacy does not interact with the beneficial effect of alteplase European Union Seventh Framework Program [FP7/2007‐2013]. Grant Number: 278276 http://hdl.handle.net/10256/19546 Teràpia trombolítica Thrombolytic therapy Isquèmia cerebral -- Tractament Cerebral ischemia -- Treatment Polimedicació Polypharmacy Polypharmacy, functional outcome and treatment effect of intravenous alteplase for acute ischaemic stroke