Abstract WMP11: Health-related Quality Of Life After Thrombolysis In Acute Stroke: Results From The Act Trial

• Published in: Stroke (1970) 2023-02, Vol.54 (Suppl_1), p.AWMP11-AWMP11
• Main Authors: Sajobi, Tolu, Ademola, Ayoola, Arimoro, Olayinka I, Singh, Nishita, Bala, Fouzi, Almekhlafi, Mohammed, Deschaintre, Yan, Appireddy, Ramana, Gubitz, Gord J, Tkach, Aleksander, Catanese, Luciana, Medvedev, George, Shankar, Jai J, Manosalva Alzate, Herbert A, Imoukhuede, Oje, Kenney, Carol C, Sehgal, Arshia, Zhang, Qiao, Doram, Craig, Zafar, Atif, Moreau, Francois, Williams, Heather, Buck, Brian H, Hill, Michael D, Swartz, Richard H, Menon, Bijoy K
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.54.suppl_1.WMP11

Background and aimsRecent evidence from thrombolysis trials indicate the non-inferiority of the Tenecteplase (TNK) to the Alteplase (TPA) with respect to functional outcomes in acute stroke patients. This study examines the predictors of patient-reported health-related quality of life (HRQOL) in acute stroke patients who received thrombolysis therapy. MethodsData were used from all acute stroke patients included in AcT, a pragmatic, registry-linked randomized trial comparing TNK with TPA. HRQOL at 90-day post-randomization was assessed using the EuroQol-5D-5L (EQ-5D) visual analogue scale (VAS). Based on the Canadian norms, health state utilities were estimated from the EQ-5D items using the EQ-5D time trade-off approach. Tobit regression model and linear mixed-effects regression were used to evaluate the adjusted effect of type of treatment on health utility scores and VAS score, respectively. ResultsOf the 1262 patients included in this analysis, 647(51.3%) were administered the TNK, 584(46.3%) were female, and 380(30.1%) were greater than or equal to 80 years old. There was no significant adjusted effect of the type of thrombolysis on health utility scores (adjusted beta coefficient [95%CI] = 0.029 [-0.001, 0.062]), but patients who received TNK reported higher adjusted VAS scores than those that received TPA [adjusted beta coefficient [95%CI] = 2.1 [-0.29, 4.49]). Older age (p < 0.01), female sex (p = 0.01), higher NIHSS score (p < 0.01) were associated with lower health utilities and VAS scores. ConclusionThere is no differential effect of the type of thrombolysis on patient-reported global HRQOL and health state utilities of acute stroke patients. Disparities in HRQOL were mainly explained by sex, age, and disease severity.