![]() Real-life studies strongly support the benefits of idarucizumab availability in stroke units and emergency departments. To optimise ICH management, the time since symptom onset, with thresholds proposed at 6 and 9 hours based on the expected timing of haematoma expansion, could also to be taken into account.Ĭonclusions: Anticoagulant reversal in patients presenting with a stroke remains a major issue, and algorithms based on a step-by-step approach may be useful for clinical practise. Due to the low risk of a prothrombotic effect, idarucizumab can be immediately used in IS patients eligible for thrombolysis before the dabigatran concentration is known. Results: For patients on non–vitamin K oral anticoagulants, reversion can be achieved with specific antidotes, but only idarucizumab, the specific dabigatran antidote, is indicated in both IS and ICH. Methods: Based on the current guidelines and additional published data, the algorithms proposed in this paper aim to help the decision-making process regarding stroke management in the setting of concurrent anticoagulants by addressing specific clinical situations based on clinical variables commonly encountered in real-world practise. Several guidelines are available but sometimes differ in their conclusions or regarding specific issues, and their application in routine emergency settings may be limited by particular individual issues or heterogeneous local specificities. 3Stroke Unit, INSERM U895, Department of Neurology, Centre Hospitalier Sud-Francilien, Paris-Saclay University, Corbeil-Essonnes, Franceīackground: The occurrence of both ischaemic (IS) and haemorrhagic stroke in patients on anticoagulation is a major issue due to the frequency of their prescriptions in westernised countries and the expected impact of anticoagulant activity on recanalization during an IS or on the outcomes associated with intracerebral haemorrhage (ICH).2Department of Interventional Neuroradiology, Rothschild Foundation Hospital, University of Paris, Laboratory of Vascular Translational Sciences, Paris, France.1Stroke Unit, Department of Neurology, Bordeaux University Hospital, Bordeaux, France.Experimental and Clinical Endocrinology and Diabetes. Low free triiodothyronine levels are related to poor prognosis in acute ischemic stroke. doi: 10.1111/j.Īmbrosius W., Kazmierski R., Gupta V., et al. European Journal of Clinical Investigation. Low triiodothyronine: a strong predictor of outcome in acute stroke patients. ![]() Neuroprotective actions of thyroid hormones and low-T3 syndrome as a biomarker in acute cerebrovascular disorders. Prolactin, cortisol secretion and thyroid function in patients with stroke of mild severity. Journal of Neurology Neurosurgery and Psychiatry. Neuroendocrine changes in patients with acute space occupying ischaemic stroke. Schwarz S., Schwab S., Klinga K., Maser-Gluth C., Bettendorf M. In sum, lower total T3 concentrations that were within the normal ranges were independently associated with poor short-term outcomes. The only other variables independently associated with poor functional outcome were NIHSS scores. On multiple logistic regression analysis, lower total T3 concentrations remained independently associated with poor functional outcome. Furthermore, score of National Institutes of Health Stroke Scale (NIHSS), total T4, free T4, and C-reactive protein at admission were significantly higher in patients with poor functional outcome, whereas free T3 and total T3 were significantly lower. On univariate analysis, poor functional outcome was associated with presence of atrial fibrillation as the index event. Total triiodothyronine (T3), total thyroxine (T4), free T3, free T4, and thyroid-stimulating hormone (TSH) were assessed to determine their values for predicting functional outcome at the first follow-up clinic visits, which usually occurred 2 to 4 weeks after discharge from the hospital. This was a retrospective study and we reviewed 1072 ischemic stroke patients consecutively admitted within 72 h after symptom onset. This study evaluated the prognostic value of thyroid-related hormones within normal ranges after acute ischemic stroke.
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