{
  "abstract": "Background In patients with acute ischaemic stroke (AIS) and concomitant non-ST-elevation acute coronary syndrome (NSTE-ACS), the role of intravenous thrombolysis (IVT) before percutaneous coronary intervention (PCI) is unclear.Methods We performed a subanalysis of the PRAISE (PRediction of Acute coronary syndrome in acute Ischemic StrokE) study, a multicentre, prospective observational study in 247 patients with AIS and elevated high-sensitivity cardiac troponin who underwent coronary angiography based on European Society of Cardiology guidelines. The impact of IVT prior to PCI on coronary artery flow (Thrombolysis in Myocardial Infarction (TIMI) score) and myocardial perfusion (TIMI myocardial perfusion score) was compared using Fisher’s exact test and logistic regression analysis, adjusting for time from stroke onset to PCI.Results Among 71 patients with AIS undergoing PCI, those who received IVT prior to PCI for NSTE-ACS (33 women; median age 77 (66–82 IQR)) achieved a TIMI grade 3 flow more frequently than those undergoing direct PCI (97% vs 79%; p=0.04). Regression analysis indicated a trend toward improved coronary artery flow with IVT (adjusted OR 8.5, 95% CI 0.9 to 75.3; p=0.05). Myocardial perfusion did not differ between groups (p=0.06).Conclusions This subanalysis suggests that IVT before PCI may enhance coronary artery flow in selected patients with NSTE-ACS with AIS. The results of this exploratory subanalysis warrant further investigation, particularly in patients with delayed access to PCI.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany"
      ],
      "name": "Annahita Sedghi"
    },
    {
      "affiliations": [
        "Department of Neurology with Experimental Neurology and Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Regina von Rennenberg"
    },
    {
      "affiliations": [
        "Department for Neurology, Section of Vascular Neurology, Universitätsklinikum Bonn, Bonn, Germany"
      ],
      "name": "Gabor Petzold"
    },
    {
      "affiliations": [
        "Department of Cardiology, Universitätsklinikum Bonn, Bonn, Germany"
      ],
      "name": "Georg Nickenig"
    },
    {
      "affiliations": [
        "Department of Neurology, University Hospital Erlangen, Erlangen, Germany"
      ],
      "name": "Bernd Kallmünzer"
    },
    {
      "affiliations": [
        "Medizinische Klinik 2, University Hospital Erlangen, Erlangen, Germany"
      ],
      "name": "Stephan Achenbach"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical Campus Lake Constance, Friedrichshafen, Germany"
      ],
      "name": "Roman Huber"
    },
    {
      "affiliations": [
        "Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany"
      ],
      "name": "Julia Seeger"
    },
    {
      "affiliations": [
        "Department of Neurology, University Medicine Greifswald, Greifswald, Germany"
      ],
      "name": "Bettina von Sarnowski"
    },
    {
      "affiliations": [
        "Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"
      ],
      "name": "Goetz Thomalla"
    },
    {
      "affiliations": [
        "Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Peter Arthur Ringleb"
    },
    {
      "affiliations": [
        "Department of Neurology, Leipzig University Hospital, Leipzig, Germany"
      ],
      "name": "Dominik Michalski"
    },
    {
      "affiliations": [
        "Department of Cardiology, Leipzig University Hospital, Leipzig, Germany"
      ],
      "name": "Ulrich Laufs"
    },
    {
      "affiliations": [
        "Neurovascular Center, Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany"
      ],
      "name": "Georg Royl"
    },
    {
      "affiliations": [
        "Department of Neurology, Mannheim Center for Translational Neuroscience, Medical Faculty Mannheim, Mannheim, Germany"
      ],
      "name": "Kristina Szabo"
    },
    {
      "affiliations": [
        "Department of Internal Medicine and Cardiology, Heart Center Dresden, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany"
      ],
      "name": "Norman Mangner"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany"
      ],
      "name": "Volker Puetz"
    },
    {
      "affiliations": [
        "Department of Neurology, LMU University Hospital, Munich, Germany"
      ],
      "name": "Lars Kellert"
    },
    {
      "affiliations": [
        "Department of Cardiology, LMU University Hospital, Munich, Germany"
      ],
      "name": "Stefan Kaeaeb"
    },
    {
      "affiliations": [
        "Department of Neurology, Klinikum Rechts der Isar, School of Medicine and Health, Technical University of Munich, Munich, Germany"
      ],
      "name": "Silke Wunderlich"
    },
    {
      "affiliations": [
        "Department of Internal Medicine I, TUM University Hospital, Technical University of Munich, Munich, Germany"
      ],
      "name": "Karl-Ludwig Laugwitz"
    },
    {
      "affiliations": [
        "Department of Neurology, Klinikum Osnabrück GmbH, Osnabrück, Germany"
      ],
      "name": "Martina Petersen"
    },
    {
      "affiliations": [
        "Department of Neurology and Stroke, Eberhard-Karls University of Tübingen, Tübingen, Germany"
      ],
      "name": "Annerose Mengel"
    },
    {
      "affiliations": [
        "Department of Cardiology, Goethe University Frankfurt, Frankfurt, Germany"
      ],
      "name": "David M Leistner"
    },
    {
      "affiliations": [
        "Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Ulf Landmesser"
    },
    {
      "affiliations": [
        "Klinik und Hochschulambulanz für Neurologie, Charite - Universitatsmedizin Berlin, Berlin, Germany",
        "Center for Stroke Research Berlin, Berlin, Germany",
        "German Center for Neurodegenerative Diseases (DZNE), partner site Berlin, Berlin, Germany",
        "German Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany",
        "German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany"
      ],
      "name": "Matthias Endres"
    },
    {
      "affiliations": [
        "Department of Neurology with Experimental Neurology and Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Christian H Nolte"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany"
      ],
      "name": "Timo Siepmann"
    }
  ],
  "title": "Intravenous thrombolysis before percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndrome and acute ischaemic stroke: a subanalysis of the PRAISE study",
  "uid": "b3637b7b-7d8d-5181-9bb8-0ad7fd8c8497"
}