{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T01:09:56Z","timestamp":1784768996824,"version":"3.55.0"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>The recommended treatment for ischemic stroke is tPA (tissue-type plasminogen activator). Although sickle cell disease (SCD) represents no known contraindication to tPA, National Heart Lung and Blood Institute of the National Institutes of Health recommended acute exchange transfusion for stroke in SCD, not tPA. Data on safety and outcomes of tPA in patients are needed to guide tPA use in SCD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We matched patients from the American Heart Association and American Stroke Association Get With The Guidelines-Stroke registry with SCD to patients without SCD and compared usage, complications, and discharge outcomes after tPA. Multivariable logistic regression models using generalized estimating equations were used to assess outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              From 2\u2009016\u2009652 stroke patients admitted to Get With The Guidelines-Stroke sites in the United States, 832 SCD and 3328 non-SCD controls with no differences in admission National Institutes of Health Stroke Scale or blood pressure were identified. Neither the fraction receiving thrombolytic therapy (8.2% for SCD versus 9.4% non-SCD) nor symptomatic intracranial hemorrhage (4.9% of SCD versus 3.2% non-SCD;\n              <jats:italic>P<\/jats:italic>\n              =0.4502) was different. There was no difference in a prespecified set of outcome measures for those with SCD compared with controls.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Coexistent SCD had no significant impact on the safety or outcome of thrombolytic therapy in acute ischemic stroke. Although the sample size is relatively small, these data suggest that adults with SCD and acute ischemic stroke should be treated with thrombolysis, if they otherwise qualify. Addition studies, however, should track the intracranial hemorrhage rate and provide information on other SCD-related care such as transfusion.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.116.015412","type":"journal-article","created":{"date-parts":[[2017,2,10]],"date-time":"2017-02-10T02:20:32Z","timestamp":1486693232000},"page":"686-691","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Coexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke"],"prefix":"10.1161","volume":"48","author":[{"given":"Robert J.","family":"Adams","sequence":"first","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margueritte","family":"Cox","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly D.","family":"Ozark","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Kanter","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip J.","family":"Schulte","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xian","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric E.","family":"Smith","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee H.","family":"Schwamm","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.J.A., S.D.O.) and Department of Pediatrics (J.K.), Medical University of South Carolina, Charleston; Duke Clinical Research Institute, Durham, NC (M.C., Y.X.); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (P.J.S.); Department of Neurology, Duke University Medical Center, Durham, NC (Y.X.); Division of Cardiology, University of California, Los Angeles (G.C.F.); Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.); and..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","first-page":"288","article-title":"Cerebrovascular accidents in sickle cell disease: rates and risk factors.","volume":"91","author":"Ohene-Frempong K","year":"1998","unstructured":"Ohene-Frempong K, Weiner SJ, Sleeper LA, Miller ST, Embury S, Moohr JW, et al.. Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood. 1998;91:288\u2013294.","journal-title":"Blood"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.9.3144"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332401"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000086"},{"key":"e_1_3_4_6_2","unstructured":"Evidence-Based Management of Sickle Cell Disease: Expert Panel Report 2014. NHLBI NIH website. http:\/\/www.nhlbi.nih.gov\/health-pro\/guidelines\/sickle-cell-disease-guidelines. Accessed April 12 2016."},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.783688"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.101"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.116.015412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T15:01:12Z","timestamp":1715612472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.116.015412"}},"subtitle":["Findings From Get With The Guidelines-Stroke"],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":7,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1161\/STROKEAHA.116.015412"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.116.015412","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]},"assertion":[{"value":"2016-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-12-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}