News Column

Findings from University of Texas Yields New Findings on Stroke (CTP infarct core may predict poor outcome in stroke patients treated with IV t-PA)

June 30, 2014



By a News Reporter-Staff News Editor at Pain & Central Nervous System Week -- New research on Stroke is the subject of a report. According to news reporting from Houston, Texas, by NewsRx journalists, research stated, "Computerized tomography perfusion (CTP) has been widely studied in assessing physiological brain tissue parameters in patients with acute ischemic stroke (AIS). The utility of CTP to predict clinical outcome in patients with AIS treated with intravenous tissue plasminogen activator (IV t-PA) is controversial."

The news correspondents obtained a quote from the research from the University of Texas, "We reviewed CTP data in AIS patients treated with IV t-PA to uncover potential predictors of clinical outcome. We retrospectively identified AIS patients from our stroke registry (7/07 to 2/10) who underwent CTP on arrival and then received IV t-PA. A neuroradiologist blinded to outcome performed all CTP parameter measurements on a commercially available Siemens Neuro PCT workstation. Tissue at risk (TAR) was defined as the area of infarct territory with a relative time to peak (rTTP) greater than 4 s. Non-viable tissue (NVT) was defined as the area of infarct territory with absolute cerebral blood volume (CBV) less than 2 ml/100 g and cerebral blood flow (CBF) less than 12.7 ml/100 g/min. Penumbra was defined as the area of (TAR) minus the area of (NVT). Excellent clinical outcome was defined as mRS (0-1), good clinical outcome was defined as mRS (0-2), and poor clinical outcome was defined as mRS (4-6), all measured at hospital discharge and 90 days if available. Recanalization data was obtained when available by comparing pre-thrombolytic CTA data and post-treatment MRA/CTA images by a single blinded radiologist. We identified 61 patients that met our inclusion criteria with a mean age of 68 (29-94), median NIHSS on admission of 13 (1-40), and median discharge mRS of 4(0-6). Using multivariate logistic regression and ordinal logistic regression controlling for age and admission NIHSS, none of the UP parameters were statistically associated with excellent or good clinical outcome (mRS < 2). Using multivariate analysis controlling for age and admission NIHSS, NVT area > 30 cm(2) (OR = 5.12, CI: 0.95-27, p = 0.05) was statistically associated with poor clinical outcome at discharge. NVT area >= 30 cm(2) was a potential predictor of poor outcome at discharge even when controlling for age and NIHSS."

According to the news reporters, the research concluded: "CTP parameters derived from commercially available software and published thresholds yield little predictive value for good clinical outcomes for AIS patients treated with IV t-PA but may be useful in predicting poor clinical outcome especially if the area of non-viable tissue is greater than 30 cm(2)."

For more information on this research see: CTP infarct core may predict poor outcome in stroke patients treated with IV t-PA. Journal of the Neurological Sciences, 2014;340(1-2):165-169. Journal of the Neurological Sciences can be contacted at: Elsevier Science Bv, PO Box 211, 1000 Ae Amsterdam, Netherlands. (Elsevier - www.elsevier.com; Journal of the Neurological Sciences - www.elsevier.com/wps/product/cws_home/506078)

Our news journalists report that additional information may be obtained by contacting T.C. Wu, Univ Texas Houston, Sch Med, Dept. of Neurol, Houston, TX 77030, United States. Additional authors for this research include C. Sitton, A. Potter, R. Bowry, P. Sahota, C.Y. Cai, P. Hui, Z.X. Chen, N. Gonzales, A. Barret, G. Lopez, J.C. Grotta and S.I. Savitz (see also Stroke).

Keywords for this news article include: Texas, Stroke, Houston, United States, North and Central America

Our reports deliver fact-based news of research and discoveries from around the world. Copyright 2014, NewsRx LLC


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Source: Pain & Central Nervous System Week


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