Examination of the Relationship between Worse Symptom and Differences Route during Administration of Argatroban in Acute Ischemic Stroke Patients

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  • Sunaga Tomiko
    Departmant of Hospital Pharmaceutics, School of Pharmacy, Showa University Department of Pharmacy, Showa University Fujigaoka Hospital
  • Higashino Mayumi
    Departmant of Hospital Pharmaceutics, School of Pharmacy, Showa University Department of Pharmacy, Showa University Fujigaoka Hospital
  • Kimura Ayasa
    Department of Pharmacology, Toxicology and Therapeutics, Division of Physiology and Pathology, School of Pharmacy, Showa University
  • Baba Yasuhiko
    Department of Neurology, Showa University Fujigaoka Hospital
  • Tanioka Toshihiro
    Department of Pharmacology, Toxicology and Therapeutics, Division of Physiology and Pathology, School of Pharmacy, Showa University
  • Watanabe Toru
    Departmant of Hospital Pharmaceutics, School of Pharmacy, Showa University Department of Pharmacy, Showa University Fujigaoka Hospital
  • Sasaki Tadanori
    Departmant of Hospital Pharmaceutics, School of Pharmacy, Showa University

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Other Title
  • 急性期脳梗塞患者におけるアルガトロバン投与中の症状悪化と投与方法の関連性についての検討
  • キュウセイキ ノウコウソク カンジャ ニ オケル アルガトロバン トウヨ チュウ ノ ショウジョウ アッカ ト トウヨ ホウホウ ノ カンレンセイ ニ ツイテ ノ ケントウ

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<p>The treatment of acute ischemic stroke usually involves argatroban administration by continuous infusion for 2 d and by intravenous infusion twice a day for 5 d after that. However, the appropriate dose of argatroban to be administered is not clear. Therefore, no studies have been reported a comparison of intravenous and continuous argatroban infusion after day 3 for acute ischemic stroke patients. We aimed to identify the connection between differences in argatroban administration and worsening of symptoms after day 3 in ischemic stroke patients. We retrospectively evaluated the data of 107 ischemic stroke patients who received treatment with argatroban. The study endpoint was defined as the worsening of symptoms from days 3 to 7. Logistic regression analysis was used to determine the risk factors that were significantly associated with worsening of symptoms. Patients were administered argatroban, with rates of 72.0%, and 28.0% for continuous, and intravenous infusion, respectively. A total of 10 (9.3%) patients experienced worsening of symptoms. In the single logistic regression analysis, carotid stenosis [non-adjusted odds ratio (OR) 5.775, 95% confidence interval (CI) 1.486-22.442, p=0.011] was only significantly associated with worsening of symptoms. Worsening of symptoms was not related to either intravenous or continuous infusion group (16.7% vs. 6.5%, p=0.104). Bleeding was also not associated with either group (6.7% vs. 3.9%, p=0.618). We suggest that the differences in the mode of argatroban administration were not related to the worsening of symptoms in ischemic stroke patients. We also found that safety was equivalent regardless of the administration route.</p>

Journal

  • YAKUGAKU ZASSHI

    YAKUGAKU ZASSHI 140 (11), 1373-1380, 2020-11-01

    The Pharmaceutical Society of Japan

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