Predicting hemorrhagic transformation in patients not submitted to reperfusion therapies

Andrade, João Brainer Clares de; Mohr, J. P.; Lima, Fabrício Oliveira; Carvalho, João José Freitas de; Farias, Victor A. E. de; Oliveira‐Filho, Jamary; Pontes-Neto, Octávio Marques; Bazan, Rodrigo; Merida, Kristel Larisa Back; Franciscato, Luisa; Pires, Matheus Mendes; Módolo, Gabriel Pinheiro; Marques, Mayara Silva; Miranda, Renata C; Silva, Gisele Sampaio

doi:10.1016/j.jstrokecerebrovasdis.2020.104940

Cited by 9 publications

(12 citation statements)

References 29 publications

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“…The clinical classification of HT is as follows: asymptomatic HT, although HTs, there is no clinical deterioration in the National Institutes of Health Stroke Scale (NIHSS) score, mild symptom HT (NIHSS score increased by 1–3 points), and severe symptom HT (Lee et al, 2019 ). HT is known to be associated with neurological deterioration in at least 20% of patients, which can increase morbidity and mortality (de Andrade et al, 2020 ). In clinical work, accurate prediction and intervention of HT will show the great significance.…”

Section: Introductionmentioning

confidence: 99%

Differential Expression and Correlation Analysis of Global Transcriptome for Hemorrhagic Transformation After Acute Ischemic Stroke

Han

Zhang

et al. 2022

Front. Neurosci.

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In order to explore the epigenetic characteristics of hemorrhagic transformation (HT) after acute ischemic stroke, we used transcriptome sequencing technology to analyze the global transcriptome expression profile of patients with and without HT after acute ischemic stroke and to study the differential expression of messenger RNA (mRNA), long noncoding RNA (lncRNA), circular RNA (circRNA) and mircoRNA (miRNA) between the two groups. To further explore the role of differentially expressed genes in HT, we annotated the function of differentially expressed genes by using gene ontology (GO) and pathway analysis on the results and showed that there were 1,051 differential expressions of lncRNAs, 2,575 differential expressions of mRNAs, 447 differential expressions of circRNAs and 47 miRNAs in patients with HT compared with non-HT patients. Pathway analysis showed that ubiquitin-mediated proteolysis, MAPK signal pathway, axon guidance, HIF-1 signal pathway, NOD-like receptor signal pathway, beta-alanine metabolism, Wnt signal pathway, sphingolipid signal pathway, neuroactive ligand-receptor interaction, and intestinal immune network used in IgA production play an important role in HT. Terms such as iron homeostasis, defense response, immune system process, DNA conformational change, production of transforming growth factor beta-2, and oxidoreductase activity were enriched in the gene list, suggesting a potential correlation with HT. A total of 261 lncRNA-miRNA relationship pairs and 21 circRNA-miRNA relationship pairs were obtained; additionally, 5 circRNAs and 13 lncRNAs were screened, which can be used as competing endogenous RNA (ceRNA) to compete with miRNA in the co-expression network. Co-expression network analysis shows that these differentially expressed circRNA and lncRNA may play a vital role in HT and provide valuable information for new biomarkers or therapeutic targets.

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Section: Introductionmentioning

confidence: 99%

Differential Expression and Correlation Analysis of Global Transcriptome for Hemorrhagic Transformation After Acute Ischemic Stroke

Han

Zhang

et al. 2022

Front. Neurosci.

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“…Consistent with this, Tu et al [ 21 ] found an association between AF and severe baseline hypoperfusion, leading to more frequent and severe HT. Moreover, previous studies indicated that clinical worsening was significantly associated with HT [ 22 , 23 , 24 ]. However, there was no significant difference in baseline NIHSS scores in the tHT cohort, similar to previous studies [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity

Chen

Lin

Long

et al. 2023

JCM

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Background: Hemorrhagic transformation (HT) is a severe complication in patients with acute ischemic stroke (AIS). This study was performed to explore and validate the relation between bilirubin levels and spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT). Methods: The study population consisted of 408 consecutive AIS patients with HT and age- and sex-matched patients without HT. All patients were divided into quartiles according to total bilirubin (TBIL) level. HT was classified as hemorrhagic infarction (HI) and parenchymal hematoma (PH) based on radiographic data. Results: In this study, the baseline TBIL levels were significantly higher in the HT than non-HT patients in both cohorts (p < 0.001). Furthermore, the severity of HT increased with increasing TBIL levels (p < 0.001) in sHT and tHT cohorts. The highest quartile of TBIL was associated with HT in sHT and tHT cohorts (sHT cohort: OR = 3.924 (2.051–7.505), p < 0.001; tHT cohort: OR = 3.557 (1.662–7.611), p = 0.006). Conclusions: Our results suggest that an increased TBIL is associated with a high risk of patients with sHT and tHT, and that TBIL is more suitable as a predictor for sHT than tHT. These findings may help to identify patients susceptible to different types and severity of HT.

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“…The increasing knowledge of risk factors for HT in the last 10 to 15 years has led to the derivation and validation of predictive scores for HT, [6][7][8][9][10][11][12][13][23][24][25][26][27] which allow to identify patients at risk for developing this complication, such as seven of them whose application in clinical practice has also been suggested by the American Stroke Association/American Heart Association (ASA/AHA) 6,[9][10][11][12][13]23,24 and others more recently proposed such as HeRS and HeRS plus, 25 PROphET, 26 and HTI. 27 The predictive power of these scores is variable, with the AUC generally ranging from 0.50 to 0.80.…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors for Hemorrhagic Transformation in Acute Ischemic Stroke in the REAL-World Clinical Practice

Grifoni¹,

Bini²,

Signorini³

et al. 2022

The Neurologist

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Background: Few data exists on predictive factors of hemorrhagic transformation (HT) in real-world acute ischemic stroke patients. The aims of this study were: (i) to identify predictive variables of HT (ii) to develop a score for predicting HT. Methods:We retrospectively analyzed the clinical, radiographic, and laboratory data of patients with acute ischemic stroke consecutively admitted to our Stroke Unit along two years. Patients with HT were compared with those without HT. A multivariate logistic regression analysis was performed to identify independent predictors of HT on CT scan at 24 hours to develop a practical score. Results:The study population consisted of 564 patients with mean age 77.5 11.8 years. Fifty-two patients (9.2%) showed HT on brain CT at 24 hours (4.9% symptomatic). NIHSS score ≥ 8 at Stroke Unit admission (3 points), cardioembolic etiology (2 points), acute revascularization by systemic thrombolysis and/or mechanical thrombectomy (1 point), history of previous TIA/stroke (1 point), and major vessel occlusion (1 point) were found independent risk factors of HT and were included in the score (Hemorrhagic Transformation Empoli score (HTE)). The predictive power of HTE score was good with an AUC of 0.785 (95% CI: 0.749-0.818). Compared with 5 HT predictive scores proposed in the literature (THRIVE, SPAN-100, MSS, GRASPS, SITS-SIC), the HTE score significantly better predicted HT.Conclusions: NIHSS score ≥ 8 at Stroke Unit admission, cardioembolism, urgent revascularization, previous TIA/stroke, and major vessel occlusion were independent predictors of HT. The HTE score has a good predictive power for HT. Prospective studies are warranted.

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Predicting hemorrhagic transformation in patients not submitted to reperfusion therapies

Cited by 9 publications

References 29 publications

Differential Expression and Correlation Analysis of Global Transcriptome for Hemorrhagic Transformation After Acute Ischemic Stroke

Differential Expression and Correlation Analysis of Global Transcriptome for Hemorrhagic Transformation After Acute Ischemic Stroke

Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity

Predictive Factors for Hemorrhagic Transformation in Acute Ischemic Stroke in the REAL-World Clinical Practice

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