{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:54:09Z","timestamp":1760986449009,"version":"3.41.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"Background<\/jats:title>Though the acute management of hypertension in patients with ischemic stroke has been associated with prolonged time to alteplase administration, it is unclear whether the choice of antihypertensive agent also influences this outcome. The purpose of this study was to evaluate the difference between nicardipine and labetalol on door-to-needle time in hypertensive patients with acute ischemic stroke.<\/jats:p><\/jats:sec>Methods<\/jats:title>This multicenter, retrospective study included all adult patients presenting to the emergency department (ED) with acute ischemic stroke between January 2018 and August 2023 who received at least one dose of labetalol or nicardipine prior to thrombolytic therapy. Patients with concomitant acute myocardial infarction, bradycardia, or history of severe aortic stenosis were excluded from the analysis. The primary outcome of this study was the time from ED arrival to alteplase administration.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 481 patients were included in the analysis: 400 (83%) received no antihypertensive, 68 (14%) received labetalol, and 13 (3%) received nicardipine prior to alteplase administration. We found no statistically significant difference in median door-to-needle times in patients who received labetalol vs. those that received nicardipine (63\u202fmin vs. 81\u202fmin, p<\/jats:italic>\u202f=\u202f0.19). Patients who did not require antihypertensive treatment had a shorter median door-to-needle time than those treated with either labetalol or nicardipine (58\u202fmin vs. 67\u202fmin, p<\/jats:italic>\u202f=\u202f0.02).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>This study did not demonstrate a significant difference in time to alteplase administration between patients treated with labetalol vs. nicardipine. Further studies are needed to determine whether the choice of antihypertensive agent used in acute ischemic stroke significantly affects clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1573352","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T04:14:42Z","timestamp":1751429682000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of nicardipine versus labetalol for time to alteplase administration in acute ischemic stroke"],"prefix":"10.3389","volume":"16","author":[{"given":"Alex","family":"Huang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Dennis","family":"Parker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Wein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2170","DOI":"10.1001\/jama.2020.5697","article-title":"Association between thrombolytic door-to-needle time and 1-year mortality and readmission in patients with acute ischemic stroke","volume":"323","author":"Man","year":"2020","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1161\/CIRCULATIONAHA.110.974675","article-title":"Timeliness of tissue-type plasminogen activator therapy in acute ischemic stroke: patient characteristics, hospital factors, and outcomes associated with door-to-needle times within 60 minutes","volume":"123","author":"Fonarow","year":"2011","journal-title":"Circulation"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e46","DOI":"10.1161\/STR.0000000000000158","article-title":"2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"49","author":"Powers","year":"2018","journal-title":"Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1161\/STROKEAHA.116.015712","article-title":"Delays in door-to-needle times and their impact on treatment time and outcomes in get with the 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trial","volume":"43","author":"Skolarus","year":"2012","journal-title":"Stroke"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s12028-008-9057-z","article-title":"A comparison of nicardipine and labetalol for acute hypertension management following stroke","volume":"9","author":"Liu-Deryke","year":"2008","journal-title":"Neurocrit Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s12028-013-9863-9","article-title":"A prospective evaluation of labetalol versus nicardipine for blood pressure management in patients with acute stroke","volume":"19","author":"Liu-DeRyke","year":"2013","journal-title":"Neurocrit Care"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1097\/JNN.0000000000000170","article-title":"Time to blood pressure control before thrombolytic therapy in patients with acute ischemic stroke: comparison of labetalol, nicardipine, and hydralazine","volume":"47","author":"McKay","year":"2015","journal-title":"J Neurosci Nurs"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"104525","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.104525","article-title":"Delay to tissue plasminogen activator in hypertensive stroke patients: an analysis of delay duration across agents","volume":"29","author":"Carrera","year":"2020","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.ajem.2021.11.037","article-title":"Comparison of intermittent versus continuous infusion antihypertensives in acute ischemic stroke","volume":"52","author":"Kamp","year":"2022","journal-title":"Am J Emerg Med"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1573352\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T04:14:43Z","timestamp":1751429683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1573352\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,2]]},"references-count":12,"alternative-id":["10.3389\/fneur.2025.1573352"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1573352","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,2]]}}}