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Angioedema associated with thrombolysis for ischemic stroke: analysis of a case-control study.

Abstract：

BACKGROUND:Bradykinin-mediated angioedema (AE) is a complication associated with thrombolysis for acute ischemic stroke. Risk factors are unknown and management is discussed. OBJECTIVES:To clarify risk factors associated with bradykinin-mediated AE after thrombolysis for acute ischemic stroke. METHODS:In a case-control study conducted at a French reference centre for bradykinin angiœdema, patients with thrombolysis for acute ischemic stroke and a diagnosis of bradykinin-mediated angiœdema, were compared to controls treated with thrombolysis treatment without angiœdema. RESULTS:Fifty-three thrombolysis-related AE were matched to 106 control subjects. The sites of attacks following thrombolysis for ischemic stroke mainly included tongue (34/53, 64%) and lips (26/53, 49%). The upper airways were involved in 37 (70%) cases. Three patients required mechanical ventilation. Patients with bradykinin-mediated angiœdema were more frequently women [33 (62%) vs. 44 (42%); P = 0.01], had higher frequency of prior ischemic stroke [12 (23%) vs. 9 (8%); P = 0.01], hypertension [46 (87%) vs. 70 (66%); P = 0.005], were more frequently treated with angiotensin-converting enzyme inhibitor [37 (70%) vs. 28 (26%); P < 0.001] and were more frequently hospitalized in intensive care medicine [ICU; 11 (21%) vs. 5 (5%); P = 0.004]. In multivariate analysis, factors associated with thrombolysis-related AE were female sex [odds ratio (OR), 3.04; 95% confident interval (CI), 1.32-7.01; P = 0.009] and treatment with angiotensin-converting enzyme inhibitors [(OR), 6.08; 95% (CI), 2.17-17.07; P < 0.001]. CONCLUSIONS:This case-control study points out angiotensin-converting enzyme inhibitors and female sex as risk factors of bradykinin AE associated with thrombolysis for ischemic stroke.

journal_name

J Intern Med

journal_title

Journal of internal medicine

authors

Vigneron C,Lécluse A,Ronzière T,Bouillet L,Boccon-Gibod I,Gayet S,Doche E,Smadja D,Di Legge S,Dumont F,Gaudron M,Ion I,Marcel S,Sévin M,Vlaicu MB,Launay D,Arnaud I,Girard-Madoux P,Héroum C,Lefèvre S,Marc G,Obadi

doi

10.1111/joim.12962

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

702-710

issue

6

eissn

0954-6820

issn

1365-2796

journal_volume

286

pub_type

杂志文章

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