Fixed Dose IV rt-PA and Clinical Outcome in Ischemic Stroke Patients With Body Weight >100 kg: Pooled Data From 3 Randomized Clinical Trials

• Published in: Journal of stroke and cerebrovascular diseases 2018-10, Vol.27 (10), p.2843-2848
• Main Authors: Majidi, Shahram, Leon Guerrero, Christopher R., Burger, Kathleen M., Sigounas, Dimitri, Olan, Wayne J., Qureshi, Adnan I.
• Format: Article
• Language: English
• Subjects: acuteischemic stroke; Aged; Aged, 80 and over; Body Weight; Brain Ischemia - diagnosis; Brain Ischemia - drug therapy; Brain Ischemia - physiopathology; Chi-Square Distribution; clinical outcome; Disability Evaluation; Female; Fibrinolytic Agents - administration & dosage; Fibrinolytic Agents - adverse effects; Humans; Infusions, Intravenous; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Randomized Controlled Trials as Topic; Recombinant Proteins - administration & dosage; Recovery of Function; Risk Factors; Stroke - diagnosis; Stroke - drug therapy; Stroke - physiopathology; thrombolysis; Thrombolytic Therapy - adverse effects; Thrombolytic Therapy - methods; Time Factors; tissue plasminogen activator; Tissue Plasminogen Activator - administration & dosage; Tissue Plasminogen Activator - adverse effects; Treatment Outcome
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2018.06.016

The ASA/AHA guidelines recommend a fixed dose of 90 mg of intravenous (IV) recombinant tissue plasminogen activator (rt-PA) for acute stroke patients weighing more than 100 kg. We aimed to determine if body weight >100 kg (and receiving 100 kg and those ≤100 kg body weight. Multivariate logistic regression model was used to identify the independent effect of >100 kg body weight on favorable 90-day outcome (defined as mRS 0-2), the rate of symptomatic intracranial hemorrhage, and poor 90-day outcome (mRS 4-6). Among 873 patients treated with IV rt-PA, a total of 105 (12%) subjects had body weight >100 kg. Compared with patients having ≤100 kg body weight, the rate of favorable outcome at 90 days was not significantly different among patients with >100 kg body weight (OR: 0.99; 95% CI: 0.91-1.01; p=0.91) , after adjusting for potential confounders. The ordinal analysis did not show any significant shift in the distribution of 90-day mRS score in patients with >100 kg body weight (OR, 0.93; 95% CI, 0.64-1.37; P = 0.74) There was no reduction in the rate of favorable outcome in patients with acute ischemic stroke with body weight >100 kg who received