Is it time to reassess the SITS-MOST criteria for thrombolysis?: A comparison of patients with and without SITS-MOST exclusion criteria

Marta Rubiera, Marc Ribo, Estevo Santamarina, Olga Maisterra, Raquel Delgado-Mederos, Pilar Delgado, Gemma Ortega, Jose Alvarez-Sabin, Carlos A. Molina

Research output: Contribution to journalArticleResearchpeer-review

37 Citations (Scopus)

Abstract

Background and Purpose - The Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) established guidelines to increase safety in acute stroke thrombolysis, but precluding treatment in an important proportion of patients. We aimed to assess safety/efficacy of thrombolysis in patients with SITS-MOST exclusion criteria. Methods - 369 nonlacunar tPA-treated patients were studied. Patients were classified as SITS-MOST (SM) or non-SITS-MOST (NSM) according to SITS-MOST-criteria fulfilling. Clinical evaluation was assessed by NIHSS and functional outcome by mRS at 3 months (functional independency=mRS ≤2). Results - Baseline NIHSS was 17. 169 (45.8%) patients were SM and 200 (54.1%) NSM. Recanalization (47.6%/50.3%, P=0.36), 24-hour-improvement (55.6%/49.5%, P=0.114), and SICH were similar (4.8%/5.1%, P=0.554). At discharge, clinical improvement in SM-group was higher (66.7%/55.7%, P=0.024). NSM tended to higher mortality (10.5%/16.1%, P=0.084) and lower functional independence (48.7%/39.6%, P=0.082). Conclusion - Thrombolysis may be safe in patients not fulfilling SITS-MOST criteria. Testing thrombolysis in patients outside SITS-MOST could be considered in the future. © 2009 American Heart Association Inc.
Original languageEnglish
Pages (from-to)2568-2571
JournalStroke
Volume40
Issue number7
DOIs
Publication statusPublished - 1 Jul 2009

Keywords

  • Acute stroke
  • Doppler
  • Guidelines
  • Thrombolysis
  • tPA

Fingerprint

Dive into the research topics of 'Is it time to reassess the SITS-MOST criteria for thrombolysis?: A comparison of patients with and without SITS-MOST exclusion criteria'. Together they form a unique fingerprint.

Cite this