Examinando por Autor "Pesántez Coronel, Andrés Esteban"
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- ÍtemAcceso AbiertoEficacia del tratamiento fibrinolítico en pacientes con accidente cerebrovascular isquémico.(Universidad Católica de Cuenca., 2024) Pesántez Coronel, Andrés Esteban; Torres Criollo, Larry Miguel; 0350233342Context: Stroke causes functional limitation in those affected, leading to frailty, worsening of the condition, and an essential demand for healthcare services. Objective: To evaluate the level of scientific evidence through a systematic review of the effectiveness of fibrinolytic therapy in patients with ischemic stroke. Methodology: A systematic review of meta-analyses and systematic reviews published between 2018 and 2023 in PubMed, Scopus, Redalyc, and ScienceDirect was conducted in English and Spanish. Results: Fibrinolysis in patients with ischemic stroke reduces disability secondary to the event. Tenecteplase significantly achieves complete recanalization in an average of 38.5% of patients compared to alteplase, which achieves it in 29%. Regarding bleeding risk, tenecteplase has an average risk of 3.05% and alteplase 2.86%, with statistically significant values (RR: 1.27 with 95% CI [1.02 - 1.57], p = 0.03). Therefore, tenecteplase is considered a reasonable option for treating patients with ischemic cerebrovascular events, considering its minimal bleeding risk compared to alteplase. Conclusions: Both medications are safe and effective for patients with ischemic stroke. Tenecteplase does not result in higher rates of intracerebral bleeding compared to alteplase. The neurological deficit in the stroke can be determined using scales, among which is the NIHSS (National Institutes of Health Stroke Scale), highlighted due to its high sensitivity and specificity. Keywords: fibrinolysis, stroke, fibrinolytic agents, cerebral infarction, treatment.