Temporal Trends of Thrombolysis Treatment in Chinese Acute Ischemic Stroke (AIS) Patients From 2007-2017: Analysis of China National Stroke Registry (CNSR) I, II, and III; CTP-Draft Review Performed;

Temporal Trends of Thrombolysis Treatment in Chinese Acute Ischemic Stroke (AIS) Patients From 2007 2017: Analysis of China National Stroke Registry (CNSR) I, II, and III

The present study is to be conducted based on the AIS patient data collected from CNSR I, II, and III.

The primary objectives are:

• To investigate the temporal changes in the proportion of intravenous recombinant plasminogen activator (IV rtPA) treatment from 2007 to 2017 among Intravenous Thrombolytics (IVT) eligible patients (patient groups B and B') and overall AIS patients (patient group A) in China;
• To investigate the temporal changes in IV rtPA treatment time intervals from 2007 to 2017 among IV rtPA treated patients (patient groups C and C') in China.

The secondary objectives are:

- To describe the demographic and clinical characteristics of the IV rtPA treated patients (patient groups C and C'), IVT eligible patients (patient groups B and B') and the overall AIS patients (patient group A) from 2007 to 2017 from the CNSR I to III.

Inclusion Criteria:

• Patient group A: All AIS patients

  • Aged 18 80 years
  • Diagnosed with AIS on admission

• Patient groups B and B': IVT eligible patients

  • Met the in- and exclusion criteria of "all AIS patients"
  • Arrived at hospital within 2 h (patient group B) or 3.5 h (patient group B') of symptom onset

• Patient groups C and C': IV rtPA treated patients

  • Met the in- and exclusion criteria of "IVT eligible patients"
  • Treated with IV rtPA within 3 h (patient group C) or 4.5 h (patient group C') of symptom onset

Exclusion Criteria:

• Patient group A: All AIS patients

  • Missing baseline data including age and gender
  • Diagnosed with intracranial hemorrhage (ICH), Transient Ischemic Attack (TIA), subarachnoid hemorrhage (SAH), or unspecific stroke
  • Arrived at hospital after 7 days of symptom onset

• Patient groups B and B': IVT eligible patients

  • Missing key data including:

    i. symptom onset time (or last known well time) ii. hospital arrival time iii. whether received IVT treatment or not iv. the time of IVT treatment

  • Documented IVT absolute contraindications, according to the case report form (CRF) for each wave of CNSR

• Patient groups C and C': IV rtPA treated patients

  • Not received IVT
  • Received IVT other than rtPA
  • Treated with IV rtPA after 3 h (patient group C) or 4.5 h (patient group C') of symptom onset
  • Received additional treatments with intra arterial reperfusion or experimental therapies