Prediction of hemorrhagic transformation in acute ischaemic stroke by micro- and macroalbuminuria after intravenous thrombolysis
Version of Record online: 14 APR 2013
© 2013 The Author(s) European Journal of Neurology © 2013 EFNS
European Journal of Neurology
Volume 20, Issue 8, pages 1145–1152, August 2013
How to Cite
Cho, B.-H., Kim, J.-T., Chang, J., Choi, K.-H., Park, M.-S. and Cho, K.-H. (2013), Prediction of hemorrhagic transformation in acute ischaemic stroke by micro- and macroalbuminuria after intravenous thrombolysis. European Journal of Neurology, 20: 1145–1152. doi: 10.1111/ene.12127
- Issue online: 5 JUL 2013
- Version of Record online: 14 APR 2013
- Manuscript Accepted: 30 JAN 2013
- Manuscript Received: 25 OCT 2012
- from the Chonnam National University Hospital Biomedical Research Institute. Grant Numbers: A102065, CRI 12008-1
- Korea Healthcare Technology R&D Project, Ministry of Health and Welfare. Grant Numbers: A102065, CRI 12008-1
- acute ischaemic stroke;
- hemorrhagic transformation;
- intravenous thrombolysis;
- parenchymal hematoma
Background and purpose
Hemorrhagic transformation (HT) is one of the most problematic complications to arise from intravenous thrombolysis (IVT). This study was conducted to assess whether micro- and macroalbuminuria could be associated with HT after IVT in patients with acute ischaemic stroke, and to investigate whether the value of urinary albumin-to-creatinine ratios would correlate with the degree of HT.
This was a retrospective study of stroke patients who had undergone IVT within 3 h of symptom onset. Albuminuria assessment was based on random morning spot urine collection with patients in a fasting state, the first morning after IVT. Multiple logistic regression analysis was used to evaluate whether the presence of micro- and macroalbuminuria might be independent predictors of HT.
One-hundred and fifty-four patients were included in the study. Fifty-one patients had HT. The presence of micro- or macroalbuminuria was associated with HT after adjustment for variables with clinical significance (adjusting for age, atrial fibrillation, platelet counts, baseline National Institutes of Health Stroke Scale score, hypertension and diabetes mellitus; odds ratio, 2.542; 95% confidence interval, 1.106–5.841; P = 0.028). There were significant relationships between the presence of micro- and macroalbuminuria and types of HT.
In conclusion, the results of this study suggest that the presence of micro- and macroalbuminuria after IVT could be a predictor of severe HT in patients with acute ischaemic stroke.