Symptomatic Hemorrhagic Transformation and Its Predictors in Acute Ischemic Stroke with Atrial Fibrillation
- Authors
- Lee, Ju-Hun; Park, Kwang-Yeol; Shin, Joon-Hyun; Cha, Jae-Kwan; Kim, Hahn-Young; Kwon, Jae-Hyun; Oh, Hyung Geun; Lee, Kyung Bok; Kim, Dong-Eog; Ha, Sang-Won; Cho, Kyung-Hee; Sohn, Sung-Il; Oh, Mi-Sun; Yu, Kyung-Ho; Lee, Byung-Chul; Kwon, Sun U.
- Issue Date
- 2010
- Publisher
- S. Karger AG
- Keywords
- Acute ischemic stroke; Atrial fibrillation; Anticoagulation; Hemorrhagic transformation
- Citation
- European Neurology, v.64, no.4, pp 193 - 200
- Pages
- 8
- Journal Title
- European Neurology
- Volume
- 64
- Number
- 4
- Start Page
- 193
- End Page
- 200
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/18582
- DOI
- 10.1159/000319048
- ISSN
- 0014-3022
1421-9913
- Abstract
- Background and Purpose: Patients with acute cardioembolic stroke frequently show hemorrhagic transformation (HTr). We attempted to identify predictors of symptomatic HTr in acute ischemic stroke with atrial fibrillation (AF). Methods: Of the consecutive acute ischemic stroke patients with AF at 12 hospitals in Korea, patients with posterior circulation stroke or thrombolytic therapy were excluded. Immediate anticoagulation was recommended to all patients, except those with: (1) large infarcts, 50% or more of the middle cerebral artery territory, (2) significant HTr on initial imaging, or (3) other safety concerns. Symptomatic HTr was defined as cerebral hemorrhage temporally related to neurological deterioration. Results: Of the 389 included patients (mean age 71 years), 260 (67%) were treated with anticoagulation within 1 week from the onset. Symptomatic HTr occurred in 4.6%. Large infarct (OR 6.38, 95% CI 1.16-35.14), previous hemorrhagic stroke (OR 10.67, 1.77-64.25), and low platelet count (OR per 10 4 increase 0.87, 0.79-0.97) were independent predictors of symptomatic HTr. hsCRP values tended to be higher in patients with symptomatic HTr (p = 0.055). Conclusions: Caution is needed in anticoagulation treatment of acute cardioembolic stroke patients with a large infarct, previous hemorrhagic stroke, low platelet count, or a high hsCRP level. Copyright (C) 2010 S. Karger AG, Basel
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Collections - College of Medicine > Department of Neurology > 1. Journal Articles
- College of Medicine > Department of Neurology > 1. Journal Articles
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