Jonatan SALDAÑA-XOLALPA, Darío HOLGUÍN-REYES, Enrique CASTELLANOS-PEDROZA, Julio César LÓPEZ-VALDÉS, Lilia NUÑEZ-OROZCO
Turkish Journal of Cerebrovascular Diseases - 2026;32(1):10-20
Background: Intravenous thrombolysis (IVT) is essential for the treatment of ischemic stroke (Is). The objective of the study was to identify reasons and predictors associated with No-IVT in patients with Is. Methods: Observational, cross-sectional, retrospective and analytical cohort study of consecutive patients with suspected e VCI in an advanced stroke center. Kolmogorov-smirnov normality test, median, interquartile range, non-parametric Kruskal-Wallis test for quantitative variables and frequencies, percentages and Chi2 in qualitative variables. Univariate and multivariate analysis in binary logistic regression for variables with P<.05. Minitab s tatistical s oftware Version 21.0.0. Results: 420 patients with Is, 112 received IVT (26.6%) and 308 (73.3%) non-IVT. The most frequent reasons for No-IVT were suspicion of stroke Mimics (Ms) (31.8%), OTD>9h (onset of symptoms-door>9h) (21.7%), non-disabling minor Is (NDMIs) (12 .01%), asPeCT s <7 (9.4%) and early improvement (6.4%). Predictors associated with No-IVT: OTD>4.5h (OR: 3.8179, p<0.001), a nticoagulation (OR: 3.7849, P=.009), NIhss 0-5 (OR: 3.3353, P=.001), Nsa (OR : 2.6599, P=.005) and asPeCT s <7 (OR: 2.4596, P=.022). Conclusion: In general, the most frequent reasons for No-IVT in middle- to low-income countries were similar to those in high-income countries, with Ms, OTD>9h, NDMIs and asPeCT s <7 being the most frequent reasons for No-IVT and The associated predictors were OTD>4.5 h, a nticoagulation, NIhss 0-5, Nsa and asPeCT s <7.
