Hemostasis functions are associated with hemorrhagic transformation in non-atrial fibrillation patients: a case-control study

Cheng, Haoran; Chen, Yunbin; Zeng, Yuxiao; Ruan, Yiting; Yuan, Chunping; Cheng, Qingyuan; Chen, Huijun; Luan, Xiaoqian; Huang, Guiqian; He, Jincai

doi:10.1186/s12883-021-02065-3

Cited by 3 publications

(2 citation statements)

References 47 publications

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“…Previous studies showed that high Fib levels were associated with a higher incidence of HT in acute ischemic stroke patients [ 44 , 45 ]. A recent study demonstrated that high Fib levels were independently associated with HT and were significantly associated with unfavorable long-term outcomes in nonatrial fibrillation patients [ 46 ]. In our study, we found that higher Fib may be an independent risk factor for HT among acute ischemic stroke patients, which is congruent with these reports.…”

Section: Discussionmentioning

confidence: 99%

Nomogram to predict hemorrhagic transformation for acute ischemic stroke in Western China: a retrospective analysis

Zhang

Luan²,

et al. 2022

BMC Neurol

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Background and purpose Hemorrhagic transformation (HT) is the most alarming complication of acute ischemic stroke. We aimed to identify risk factors for HT in Chinese patients and attempted to develop a nomogram to predict individual cases. Methods A retrospective study was used to collect the demographic and clinical characteristics of ischemic stroke patients at the Second Affiliated Hospital of Chongqing Medical University (development cohort) and Chongqing Sanbo Changan Hospital (validation cohort) from October 2013 to August 2020. Univariate analysis and multivariate analysis were used to identify the risk factors of patients in the development cohort. The nomogram was generated, and internal validation was performed. We used the area under the receiver-operating characteristic curve (AUC-ROC) to assess the discrimination and used the Hosmer–Lemeshow test to calibrate the model. To further verify the predictability and accuracy of the model, we performed an external validation of the patients in the validation cohort. Results A total of 570 patients were used to generate the nomogram. After univariate analysis and multivariate logistic regression, the remaining 7 variables (diabetes mellitus, atrial fibrillation, total cholesterol, fibrous protein, cerebral infarction area, NIHSS score and onset-to-treatment) were independent predictors of HT and used to compose the nomogram. The area under the receiver-operating characteristic curve of the model was 0.889 (95% CI, 0.841–0.938), and the calibration was good (P = 0.487 for the Hosmer–Lemeshow test). The model was validated externally with an AUC-ROC value of 0.832 (95% CI, 0.727–0.938). Conclusions The nomogram prediction model in this study has good predictive ability, accuracy and discrimination, which can improve the diagnostic efficiency of HT in patients with acute ischemic stroke.

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Section: Discussionmentioning

confidence: 99%

Nomogram to predict hemorrhagic transformation for acute ischemic stroke in Western China: a retrospective analysis

Zhang

Luan²,

et al. 2022

BMC Neurol

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“…In a case–control study, Cheng et al found that low platelet count, low mean platelet volume (MPV), and high fibrinogen (FIB) levels were significant and independent risk factors of HT in non-atrial fibrillation (AF) patients but not in AF patients. They concluded that MPV and FIB levels were independently and significantly associated with unfavorable long-term functional outcomes in non-AF HT patients [ 57 ].…”

Section: Clinical Risk Factors Of Htmentioning

confidence: 99%

Hemorrhagic Transformation of Ischemic Strokes

Kovács,

Bencs,

Hudák

et al. 2023

IJMS

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Ischemic stroke, resulting from insufficient blood supply to the brain, is among the leading causes of death and disability worldwide. A potentially severe complication of the disease itself or its treatment aiming to restore optimal blood flow is hemorrhagic transformation (HT) increasing morbidity and mortality. Detailed summaries can be found in the literature on the pathophysiological background of hemorrhagic transformation, the potential clinical risk factors increasing its chance, and the different biomarkers expected to help in its prediction and clinical outcome. Clinicopathological studies also contribute to the improvement in our knowledge of hemorrhagic transformation. We summarized the clinical risk factors of the hemorrhagic transformation of ischemic strokes in terms of risk reduction and collected the most promising biomarkers in the field. Also, auxiliary treatment options in reperfusion therapies have been reviewed and collected. We highlighted that the optimal timing of revascularization treatment for carefully selected patients and the individualized management of underlying diseases and comorbidities are pivotal. Another important conclusion is that a more intense clinical follow-up including serial cranial CTs for selected patients can be recommended, as clinicopathological investigations have shown HT to be much more common than clinically suspected.

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The differences of fibrinogen levels in various types of hemorrhagic transformations

Long,

Chen,

Huang

et al. 2024

Front. Neurol.

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IntroductionHemorrhagic transformation (HT) is a serious complication that can occur spontaneously after an acute ischemic stroke (AIS) or after a thrombolytic/mechanical thrombectomy. Our study aims to explore the potential correlations between fibrinogen levels and the occurrence of spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT).MethodsA total of 423 consecutive AIS patients diagnosed HT who did not undergone thrombolysis and 423 age- and sex-matched patients without HT (non-HT) were enrolled. Fibrinogen levels were measured within 24 h of admission after stroke. The cohorts were trisected according to fibrinogen levels. The HT were further categorized into hemorrhagic infarction (HI) or parenchymal hematoma (PH) based on their imaging characteristics.ResultsIn sHT cohort, fibrinogen levels were higher in HT patients than non-HT patients (p < 0.001 versus p = 0.002). High fibrinogen levels were associated with the severity of HT. HT patients without atrial fibrillation (AF) had higher levels of fibrinogen compared to non-HT (median 3.805 vs. 3.160, p < 0.001). This relationship did not differ among AF patients. In tHT cohort, fibrinogen levels were lower in HT patients than non-HT patients (p = 0.002). Lower fibrinogen levels were associated with the severity of HT (p = 0.004). The highest trisection of fibrinogen both in two cohorts were associated with HT [sHT cohort: OR = 2.515 (1.339–4.725), p = 0.016; that cohort: OR = 0.238 (0.108–0.523), p = 0.003].ConclusionOur study suggests that lower fibrinogen level in sHT without AF and higher fibrinogen level in tHT are associated with more severe HT.

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Hemostasis functions are associated with hemorrhagic transformation in non-atrial fibrillation patients: a case-control study

Cited by 3 publications

References 47 publications

Nomogram to predict hemorrhagic transformation for acute ischemic stroke in Western China: a retrospective analysis

Nomogram to predict hemorrhagic transformation for acute ischemic stroke in Western China: a retrospective analysis

Hemorrhagic Transformation of Ischemic Strokes

The differences of fibrinogen levels in various types of hemorrhagic transformations

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