Frequency and risk factors of spontaneous hemorrhagic transformation following ischemic stroke on the initial brain CT or MRI: data from the China National Stroke Registry (CNSR)

Chen, Guojuan; Wang, Anxin; Zhao, Xingquan; Wang, Chunxue; Liu, Liping; Zheng, Huaguang; Wang, Yongjun; Cao, Yibin; Wang, Yilong

doi:10.1080/01616412.2016.1187864

Cited by 26 publications

(13 citation statements)

References 25 publications

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“…Interestingly, our study found that SBP on admission was significantly lower in patients with HT (140 ± 23 mmHg) than those without HT (146 ± 23 mmHg), which is in line with some previous studies [36][37][38]. A possible explanation might be that slightly elevated blood pressure could provide an adequate cerebral blood supply, and thereby reduce the damage to blood-brain barrier due to ischemia and hypoxia [39], which may prevent the occurrence of HT.…”

Section: Discussionsupporting

confidence: 91%

Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

et al. 2020

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Background It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare the predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT. Methods We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT in multivariate logistic regression analysis. Results A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted odds ratios [ORs] 1.74 [95% confidence interval [CI] 1.09–2.78], 2.01[95% CI 1.26–3.20], and 1.76 [95% CI 1.10–2.83], respectively, P for trend = 0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age (P for interaction = 0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values [Non-HDL-C, net reclassification index (NRI) 0.24, 95%CI 0.17–0.31, P < 0.001; LDL-C, NRI 0.15, 95%CI 0.08–0.22, P = 0.03]. Conclusions Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT.

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Section: Discussionsupporting

confidence: 91%

Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

et al. 2020

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“…Similar results were noted in those with ischemic stroke after thrombolysis ( 3 , 25 , 33 , 34 ). In previous studies on patients without thrombolysis, although univariate analysis showed that patients with higher NIHSS score were more prone to HT, NIHSS score was not an independent risk factor for HT ( 2 , 19 , 20 ). This is perhaps explained by the smaller sample sizes of previous studies and the fact that previous studies only investigated the relationship between HT and NIHSS score at admission rather than the relationship between sICH and NIHSS score at admission.…”

Section: Discussionmentioning

confidence: 78%

“…But this is a single-center study with only 406 patients included. Another study based on a multicenter registry analyzed sICH in those who did not receive any antithrombotic therapy ( 20 ), while most patients with acute ischemic stroke would receive antithrombotic treatment after stroke, of which approximately one third underwent antiplatelet therapy (APT) prior to the onset of stroke in the real world ( 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%

Predictors and Prognosis of Symptomatic Intracranial Hemorrhage in Acute Ischemic Stroke Patients Without Thrombolysis: Analysis of Data From the Chinese Acute Ischemic Stroke Treatment Outcome Registry

Shen

Jin

et al. 2021

Front. Neurol.

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Background and Purpose: There is limited information on symptomatic intracranial hemorrhage (sICH) in stroke patients without thrombolysis. This study aimed to evaluate the risk factors of sICH and the association between sICH and the prognosis at 3 and 12 months in acute ischemic stroke patients without thrombolysis.Methods: Data originated from the Chinese Acute Ischemic Stroke Treatment Outcome Registry. Univariate analysis and multivariate logistic regression were used to screen the risk factors of sICH. Multivariable logistic regression models were used to assess the association of sICH with poor outcome and all-cause mortality.Results: Totally, 9,484 patients were included, of which 69 (0.73%) had sICH. Atrial fibrillation (odds ratio [OR], 3.682; 95% confidence interval [CI], 1.945–6.971; p < 0.001), history of tumors (OR, 2.956; 95% CI, 1.115–7.593; p = 0.024), and the National Institutes of Health Stroke Scale (NIHSS) score on admission ([6–15: OR, 2.344; 95% CI, 1.365–4.024; p = 0.002] [>15: OR, 4.731; 95% CI, 1.648–13.583; p = 0.004]) were independently associated with sICH. After adjustment of the confounders, patients with sICH had a higher risk of poor outcome (OR, 1.983; 95% CI, 1.117–3.521; p = 0.018) at 3 months and that of all-cause mortality at 3 (OR, 6.135; 95% CI, 2.328–16.169; p < 0.001) and 12 months (OR, 3.720; 95% CI, 1.513–9.148; p = 0.004).Conclusion: sICH occurred in 0.73% of acute ischemic stroke patients without thrombolysis and was associated with a worse prognosis at 3 and 12 months. Atrial fibrillation, history of tumors, and NIHSS score at admission were independent risk factors of sICH.

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“…[ [36][37][38] A possible explanation might be that slightly elevated blood pressure could provide an adequate cerebral blood supply, and thereby reduce the damage to blood-brain barrier due to ischemia and hypoxia,[39] which may prevent the occurrence of HT. A much-debated question is whether blood pressure is related to HT.…”

Section: Discussionmentioning

confidence: 99%

Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

Wang

Song

Cheng

et al. 2019

Preprint

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Background : It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare the predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT. Methods: We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT in multivariate logistic regression analysis. Results: A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted Odds ratios [ORs] 1.74 [95% Confidence Interval [CI] 1.09-2.78], 2.01[95% CI 1.26-3.20], and 1.76 [95% CI 1.10-2.83], respectively, P for trend=0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age ( P for interaction=0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values (Non-HDL-C, net reclassification index [NRI] 0.24, 95%CI 0.17-0.31, P<0.001; LDL-C, NRI 0.15, 95%CI 0.08-0.22, P=0.03). Conclusions: Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT. Keywords: Non-high-density lipoprotein cholesterol, Haemorrhagic transformation, Acute ischaemic stroke

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Frequency and risk factors of spontaneous hemorrhagic transformation following ischemic stroke on the initial brain CT or MRI: data from the China National Stroke Registry (CNSR)

Abstract: Spontaneous HT occurred in 0.92% of the patients with IS in the acute stage. Being female, excess alcohol consumption, atrial fibrillation, and a prolonged period between IS onset and initial imaging were associated with an increased risk of spontaneous HT.

Cited by 26 publications

References 25 publications

Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

Predictors and Prognosis of Symptomatic Intracranial Hemorrhage in Acute Ischemic Stroke Patients Without Thrombolysis: Analysis of Data From the Chinese Acute Ischemic Stroke Treatment Outcome Registry

Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

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