Serum Albumin Is Negatively Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients

Abstract

Background and Objective: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke (AIS). Serum albumin is known for its neuroprotective effects and is a marker of improved AIS patient outcomes. However, it is not known whether there is a relationship between serum albumin and HT. Methods: AIS patients admitted to the Department of Neurology of West China Hospital from 2012 to 2016 were prospectively and consecutively enrolled. Baseline characteristics were collected. HT during hospitalization was diagnosed by brain imaging. Multivariate logistic regression analysis was performed to determine the relationship between serum albumin and HT. Confounding factors were identified by univariate analysis. Stratified logistic regression analysis was performed to identify effect modifiers. Results: A total of 1996 AIS patients were recruited, of whom 135 (6.8%) developed HT. Serum albumin negatively correlated with HT. Patients in the upper serum albumin tertile (42.6–54.1 g/L) had a 46% lower risk of HT than patients in the lower tertile (19.3–39.1 g/L) after adjustment for potential confounders (OR 0.54, 95% CI 0.29–0.99, p = 0.04). Risk of HT decreased stepwise with higher serum albumin tertile (p for trend = 0.04). There was a significant interaction between serum albumin and age (p = 0.02), with no significant correlation between serum albumin and HT in patients over 60 years of age. Conclusions: Higher serum albumin is associated with lower HT risk in a dose-dependent manner in AIS patients younger than 60 years.

Predictors of death within 6 months of stroke onset: A model with Barthel index, platelet/lymphocyte ratio and serum albumin

“…Wang et al. (2019) showed that when serum albumin was higher in patients with acute ischaemic stroke and younger than 60 years, the risk of haemorrhagic transformation was gradually reduced, so it is a marker for improving the prognosis of patients with ischaemic stroke. Our findings are similar and suggest that serum albumin is an independent risk factor for death within 6 months of onset of stroke.…”

Study on the Mechanism of Zhilong Huoxue Tongyu Capsule in the Treatment of Ischemic Stroke Based on Network Pharmacology and Molecular Docking Technology

“…Low ALB level is associated with poor neurological prognosis in acute ischemic stroke. Therefore, serum ALB is known for its neuroprotective effect and is a marker for improving the prognosis of patients with acute ischemic stroke [15] . TNF is an important mediator of inflammatory response, involved in every stage of stroke-related neuronal damage, such as inflammation and prothrombotic events.…”

Elevated Albumin to Globulin Ratio on Day 7 is Associated with Improved Function Outcomes in Acute Ischemic Stroke Patients with Intravenous Thrombolysis

“…Previous literatures suggested that lower serum Alb level was associated with worse neurological state and poor function outcomes in all the AIS subtypes classified based on TOAST 30 , 31 and higher odds of hemorrhagic transformation post-AIS. 32 However, the second analysis of ALIAS (Albumin in Acute Ischemic Stroke) Trials and the latest meta-analysis suggested that albumin therapy was not associated with improved outcome at 3 months but associated with higher risks of pulmonary edema and other complications. 33 , 34 In our study, the level of albumin was lower in patients with a poor outcome, though albumin at any time-point (admission, 24 h, and day 7) was not a significant predictor of a poor outcome after adjusting for potential confounders.…”