Clinicoetiological profile of acute ischemic stroke patients in the therapeutic window in a tertiary care hospital in Northern India

Abstract

Background: A stroke is defined by the rapid emergence of clinical symptoms and focuses on evidence (applicable to individuals in a deep coma and those with subarachnoid hemorrhage) or widespread brain damage. The study aimed to evaluate the clinical characteristics of patients with acute ischemic stroke in a tertiary care hospital in North India. Methods: By analyzing case files and conducting patient interviews, information on the patients was gathered and evaluated. The study's inclusion and exclusion criteria were based on the 2018 American Heart Association and American Stroke Association (AHA/ASA) thrombolysis guidelines for acute ischemic stroke. Recent major trauma or major surgery within 14 days not involving the head, seizure at the onset of stroke, systemic malignancy, and pregnancy were excluded. Results: The study enlisted the participation of 76 patients who were divided into two groups. Patients in the one group were given tenecteplase, whereas the other group were given alteplase. Patients in the tenecteplase and alteplase groups were of different ages and had various other risk factors for hypertension, atrial fibrillation, diabetes, smoking, and previous stroke or transient ischemic attack. The risk factor distribution in both the groups was statistically significant for variables such as hypertension and diastolic blood pressure (P < 0.05). Stroke in internal carotid artery territory was present in 3 out of 42 in the tenecteplase group and 2 out of 32 in the alteplase group. Most patients in both the groups had a stroke of undetermined cause. Small vessel and large vessel strokes were found in 9.5% and 14.7%, respectively. Conclusion: In the development of stroke, there is a definite relationship between age and gender. A sedentary lifestyle, food, and obesity are risk factors for stroke. According to an AHA/ASA drug utilization analysis, most medicines were appropriate for stroke patients.