Symptomatic hemorrhagic transformation and its predictors in acute ischemic stroke with atrial fibrillation
| Autor: | Kyung Ho Yu, Kwang-Yeol Park, Jee Hyun Kwon, Mi Sun Oh, Sun U. Kwon, Sung Il Sohn, Kyung Hee Cho, Ju-Hun Lee, Kyung Bok Lee, Jae Kwan Cha, Byung-Chul Lee, Hahn Young Kim, Dong-Eog Kim, Sang Won Ha, Joon Hyun Shin, Hyung Geun Oh |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Brain Ischemia Predictive Value of Tests medicine.artery Internal medicine Atrial Fibrillation Republic of Korea medicine Humans cardiovascular diseases Registries Acute ischemic stroke Stroke Aged Cerebral Hemorrhage Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Incidence (epidemiology) Incidence Anticoagulants Magnetic resonance imaging Atrial fibrillation Retrospective cohort study Middle Aged medicine.disease Magnetic Resonance Imaging Logistic Models Neurology Predictive value of tests Middle cerebral artery Cardiology Female Neurology (clinical) business Tomography X-Ray Computed |
| Zdroj: | European neurology. 64(4) |
| ISSN: | 1421-9913 |
| Popis: | Background and Purpose: Patients with acute cardioembolic stroke frequently show hemorrhagic transformation (HTr). We attempted to identify predictors of symptomatic HTr in acute ischemic stroke with atrial fibrillation (AF). Methods: Of the consecutive acute ischemic stroke patients with AF at 12 hospitals in Korea, patients with posterior circulation stroke or thrombolytic therapy were excluded. Immediate anticoagulation was recommended to all patients, except those with: (1) large infarcts, 50% or more of the middle cerebral artery territory, (2) significant HTr on initial imaging, or (3) other safety concerns. Symptomatic HTr was defined as cerebral hemorrhage temporally related to neurological deterioration. Results: Of the 389 included patients (mean age 71 years), 260 (67%) were treated with anticoagulation within 1 week from the onset. Symptomatic HTr occurred in 4.6%. Large infarct (OR 6.38, 95% CI 1.16–35.14), previous hemorrhagic stroke (OR 10.67, 1.77–64.25), and low platelet count (OR per 104 increase 0.87, 0.79–0.97) were independent predictors of symptomatic HTr. hsCRP values tended to be higher in patients with symptomatic HTr (p = 0.055). Conclusions: Caution is needed in anticoagulation treatment of acute cardioembolic stroke patients with a large infarct, previous hemorrhagic stroke, low platelet count, or a high hsCRP level. |
| Databáze: | OpenAIRE |
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