Success rate and determinants of intravenous thrombolysis in acute ischemic stroke from the Malaysia National Stroke Registry
Abstract
Intravenous thrombolysis (IVT) is an established intervention for acute ischemic stroke (AIS), yet comprehensive real-world evidence on its success rate and determinants in low and middle countries (LMCs) remains limited. This retrospective cohort study aimed to determine the success rate of IVT and identify key determinants using data from the Malaysian National Stroke Registry (2014–2023) from two tertiary hospitals. Successful IVT was defined as a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 4 at 24 h post-IVT. Individual-related, clinical-related, and treatment-related determinants were included as the independent variables. Multiple logistic regression was used to identify the determinants of successful IVT. A total of 1,011 eligible patients were included in the study with a median (IQR) age of 62.0 (19.0) years and 61.3% were males. The success rate of IVT was 37.8% (95% CI 34.8–40.8), with median onset-to-needle time of 192.0 (95.0) minutes. Younger age (adjusted odds ratio (aOR) 0.99 (95% CI 0.98–0.99)), lower baseline NIHSS score (aOR 0.87 (95% CI 0.84–0.89)), and small vessel occlusion subtype (aOR 2.52 (95% CI 1.65–3.86)) were significant determinants of successful IVT. These findings highlight important determinants that may help optimize IVT delivery and improve stroke outcomes in Malaysia.
Related
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- Machine learning-based models to predict 90-day non-excellent functional outcomes among patients with mild acute ischemic stroke after intravenous thrombolysis
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- Association of the remnant cholesterol inflammation index with long-term outcomes among patients with acute ischemic stroke treated with intravenous thrombolysis
BibTeX
@article{sies2026success,
title = {{Success rate and determinants of intravenous thrombolysis in acute ischemic stroke from the Malaysia National Stroke Registry}},
author = {Nur Syazmin Sies and Aimi Nadira Mat Ruzlin and Norsima Nazifah Sidek and Khairul Azmi Ibrahim and Wan Chung Law and Teck Long King and Xin Wee Chen},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-72471-5},
url = {https://www.nature.com/articles/s41598-026-72471-5},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Success rate and determinants of intravenous thrombolysis in acute ischemic stroke from the Malaysia National Stroke Registry
AU - Nur Syazmin Sies
AU - Aimi Nadira Mat Ruzlin
AU - Norsima Nazifah Sidek
AU - Khairul Azmi Ibrahim
AU - Wan Chung Law
AU - Teck Long King
AU - Xin Wee Chen
PY - 2026
DA - 2026/10/01
JO - Scientific Reports
DO - 10.1038/s41598-026-72471-5
UR - https://www.nature.com/articles/s41598-026-72471-5
AB - Intravenous thrombolysis (IVT) is an established intervention for acute ischemic stroke (AIS), yet comprehensive real-world evidence on its success rate and determinants in low and middle countries (LMCs) remains limited. This retrospective cohort study aimed to determine the success rate of IVT and identify key determinants using data from the Malaysian National Stroke Registry (2014–2023) from two tertiary hospitals. Successful IVT was defined as a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 4 at 24 h post-IVT. Individual-related, clinical-related, and treatment-related determinants were included as the independent variables. Multiple logistic regression was used to identify the determinants of successful IVT. A total of 1,011 eligible patients were included in the study with a median (IQR) age of 62.0 (19.0) years and 61.3% were males. The success rate of IVT was 37.8% (95% CI 34.8–40.8), with median onset-to-needle time of 192.0 (95.0) minutes. Younger age (adjusted odds ratio (aOR) 0.99 (95% CI 0.98–0.99)), lower baseline NIHSS score (aOR 0.87 (95% CI 0.84–0.89)), and small vessel occlusion subtype (aOR 2.52 (95% CI 1.65–3.86)) were significant determinants of successful IVT. These findings highlight important determinants that may help optimize IVT delivery and improve stroke outcomes in Malaysia.
SN - 2045-2322
ER -