Send to

Choose Destination
See comment in PubMed Commons below
Neurology. 2013 Nov 12;81(20):1773-5. doi: 10.1212/ Epub 2013 Oct 4.

Safety of IV thrombolysis in acute ischemic stroke related to Chagas disease.

Author information

  • 1From the Ribeirão Preto School of Medicine, University of Sao Paulo, Ribeirão Preto, Brazil.



To determine the rate of symptomatic intracranial hemorrhage (SIH) and in-hospital mortality among patients with acute ischemic stroke related to Chagas disease (CD) treated with IV tissue plasminogen activator (TPA).


In this retrospective cohort study, consecutive stroke patients treated with IV TPA and routinely tested for CD were retrospectively selected from a single-center, hospital-based, prospective registry of acute stroke patients from 2001 to 2012. Demographic and clinical data were obtained from the registry as well as in-hospital mortality. CT scans were blindly reviewed to assess the occurrence of hemorrhagic transformation. Among acute stroke patients who received IV TPA, we compared those with and without a positive serology for CD.


Among 240 patients treated with IV TPA, 174 had serologic testing for CD available. Of those, 24 patients (13.8%) had positive serology for CD. Patients with CD more frequently had heart failure (45.8% vs 14.7%; p < 0.01) and higher admission NIH Stroke Scale scores (19 [15-21] vs 13 [8-19]; p < 0.01) than patients with negative serology. The rates of SIH (4.2% vs 5.3%; odds ratio: 0.77; 95% confidence interval: 0.09-6.46; p = 0.99) and in-hospital death (16.7% vs 11.3%; odds ratio: 1.57; 95% confidence interval: 0.48-5.12; p = 0.50) were not higher among patients with CD.


In the largest published series of patients with CD-related stroke treated with IV TPA, we have observed that IV thrombolysis was safely performed and showed no increase of SIH. The diagnosis of CD should not preclude IV thrombolysis in these patients.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center