Hao-Ran Cheng1, Yun-Bin Chen1, Ya-Ying Zeng1, Yi-Ting Ruan1, Cheng-Xiang Yuan1, Qian-Qian Cheng2, Hui-Jun Chen1, Xiao-Qian Luan1, Gui-Qian Huang3, Jin-Cai He4. 1. Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China. 2. School of Mental Health, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China. 3. Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China. huangguiqian123@126.com. 4. Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China. hjc@wmu.edu.cn.
Abstract
BACKGROUND: Hemorrhagic transformation (HT) is a serious neurological complication of acute ischemic stroke (AIS) after revascularization. The majority of AIS patients do not have atrial fibrillation (AF) which could also develop into HT. In this study, we aimed to explore whether hemostasis parameters are risk factors of HT in non-AF patients. METHODS: We consecutively enrolled 285 AIS patients with HT. Meanwhile, age- and sex-matched 285 AIS patients without HT were included. The diagnosis of HT was determined by brain CT or MRI during hospitalization. All patients were divided into two subgroups based on the presence of AF and explore the differences between the two subgroups. Blood samples were obtained within 24 h of admission, and all patients were evenly classified into three tertiles according to platelet counts (PLT) levels. RESULTS: In this study, we found the first PLT tertile (OR = 3.509, 95%CI = 1.268-9.711, P = 0.016) was independently associated with HT in non-AF patients, taking the third tertile as a reference. Meanwhile, we also found mean platelet volume (MPV) (OR = 0.605, 95%CI = 0.455-0.805, P = 0.001) and fibrinogen (FIB) (OR = 1.928, 95%CI = 1.346-2.760, P < 0.001) were significantly associated with HT in non-AF patients. But in AF patients, hemostasis parameters showed no significant difference. Meanwhile, we found the MPV (OR = 1.314, 95%CI = 1.032-1.675, P = 0.027) and FIB (OR = 1.298, 95%CI = 1.047-1.610, P = 0.018) were significantly associated with long-term outcomes in non-AF HT patients. CONCLUSIONS: Low PLT, low MPV, and high FIB levels were independently associated with HT in non-AF patients. Additionally, MPV and FIB levels were significantly associated with unfavorable long-term outcomes in non-AF HT patients. Our study showed that hemostasis functions at admission may be beneficial for clinicians to recognize patients with a high risk of HT at an early stage and improve unfavorable long-term outcomes in non-AF patients.
BACKGROUND:Hemorrhagic transformation (HT) is a serious neurological complication of acute ischemic stroke (AIS) after revascularization. The majority of AISpatients do not have atrial fibrillation (AF) which could also develop into HT. In this study, we aimed to explore whether hemostasis parameters are risk factors of HT in non-AFpatients. METHODS: We consecutively enrolled 285 AISpatients with HT. Meanwhile, age- and sex-matched 285 AISpatients without HT were included. The diagnosis of HT was determined by brain CT or MRI during hospitalization. All patients were divided into two subgroups based on the presence of AF and explore the differences between the two subgroups. Blood samples were obtained within 24 h of admission, and all patients were evenly classified into three tertiles according to platelet counts (PLT) levels. RESULTS: In this study, we found the first PLT tertile (OR = 3.509, 95%CI = 1.268-9.711, P = 0.016) was independently associated with HT in non-AFpatients, taking the third tertile as a reference. Meanwhile, we also found mean platelet volume (MPV) (OR = 0.605, 95%CI = 0.455-0.805, P = 0.001) and fibrinogen (FIB) (OR = 1.928, 95%CI = 1.346-2.760, P < 0.001) were significantly associated with HT in non-AFpatients. But in AFpatients, hemostasis parameters showed no significant difference. Meanwhile, we found the MPV (OR = 1.314, 95%CI = 1.032-1.675, P = 0.027) and FIB (OR = 1.298, 95%CI = 1.047-1.610, P = 0.018) were significantly associated with long-term outcomes in non-AF HTpatients. CONCLUSIONS: Low PLT, low MPV, and highFIB levels were independently associated with HT in non-AFpatients. Additionally, MPV and FIB levels were significantly associated with unfavorable long-term outcomes in non-AF HTpatients. Our study showed that hemostasis functions at admission may be beneficial for clinicians to recognize patients with a high risk of HT at an early stage and improve unfavorable long-term outcomes in non-AFpatients.
Entities:
Keywords:
Acute ischemic stroke; Atrial fibrillation; Hemorrhagic transformation; Hemostasis function
Authors: A Guenego; A Lecler; J Raymond; C Sabben; N Khoury; K Premat; D Botta; W Boisseau; B Maïer; G Ciccio; H Redjem; S Smajda; C Ducroux; L Di Meglio; V Davy; J M Olivot; A Wang; J Duplantier; M Roques; S Krystal; P Koskas; A Collin; M Ben Maacha; M Hamdani; K Zuber; R Blanc; M Piotin; R Fahed Journal: Eur J Neurol Date: 2018-12-07 Impact factor: 6.089