Associations between computed tomography markers of cerebral small vessel disease and hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients

doi:10.3389/fneur.2023.1144564

科研成果详情

题名	Associations between computed tomography markers of cerebral small vessel disease and hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients
作者	Zhan, Zhenxiang 1,2; Xu, Tong1; Xu, Ye1; Fu, Fangwang1; Cheng, Zicheng 2; Xia, Lingfan1; Wu, Yucong1; Xu, Xuan1; Cao, Yungang 1; Han, Zhao1
发表日期	2023-04-03
发表期刊	FRONTIERS IN NEUROLOGY 影响因子和分区
语种	英语
原始文献类型	Article
关键词	acute ischemic stroke intravenous thrombolysis hemorrhagic transformation brain atrophy cerebral small vessel disease leukoaraiosis
其他关键词	TISSUE-PLASMINOGEN ACTIVATOR ; WHITE-MATTER LESIONS ; INTRACEREBRAL HEMORRHAGE ; RISK ; ALTEPLASE ; OUTCOMES ; METAANALYSIS ; MICROBLEEDS ; TRIAL ; CT
摘要	BackgroundHemorrhagic transformation (HT) is common among acute ischemic stroke patients after treatment with intravenous thrombolysis (IVT). We analyzed potential relationships between markers of cerebral small vessel disease (CSVD) and HT in patients after IVT. MethodsThis study retrospectively analyzed computed tomography (CT) data for acute ischemic stroke patients before and after treatment with recombinant tissue plasminogen activator at a large Chinese hospital between July 2014 and June 2021. Total CSVD score were summed by individual CSVD markers including leukoaraiosis, brain atrophy and lacune. Binary regression analysis was used to explore whether CSVD markers were related to HT as the primary outcome or to symptomatic intracranial hemorrhage (sICH) as a secondary outcome. ResultsA total of 397 AIS patients treated with IVT were screened for inclusion in this study. Patients with missing laboratory data (n = 37) and patients treated with endovascular therapy (n = 42) were excluded. Of the 318 patients included, 54 (17.0%) developed HT within 24-36 h of IVT, and 14 (4.3%) developed sICH. HT risk was independently associated with severe brain atrophy (OR 3.14, 95%CI 1.43-6.92, P = 0.004) and severe leukoaraiosis (OR 2.41, 95%CI 1.05-5.50, P = 0.036), but not to severe lacune level (OR 0.58, 95%CI 0.23-1.45, P = 0.250). Patients with a total CSVD burden >= 1 were at higher risk of HT (OR 2.87, 95%CI 1.38-5.94, P = 0.005). However, occurrence of sICH was not predicted by CSVD markers or total CSVD burden. ConclusionIn patients with acute ischemic stroke, severe leukoaraiosis, brain atrophy and total CSVD burden may be risk factors for HT after IVT. These findings may help improve efforts to mitigate or even prevent HT in vulnerable patients.
资助项目	Clinical Scientific Research Foundation of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University [SAHoWMU-CR2017-01-212]
出版者	FRONTIERS MEDIA SA
ISSN	1664-2295
卷号	14
DOI	10.3389/fneur.2023.1144564
页数	7
WOS类目	Clinical Neurology ; Neurosciences
WOS研究方向	Neurosciences & Neurology
WOS记录号	WOS:000970480300001
收录类别	SCIE ; SCOPUS ; PUBMED
URL	查看原文
PubMed ID	37077565
SCOPUSEID	2-s2.0-85153504623
通讯作者地址	[Han, Zhao]Department of Neurology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,China
Scopus学科分类	Neurology;Neurology (clinical)
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/174857
专题	第二临床医学院，附属第二医院、育英儿童医院_神经病学_神经内科
通讯作者	Han, Zhao
作者单位	1.Department of Neurology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,China; 2.Department of Neurology,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua,China
第一作者单位	第二临床医学院，附属第二医院、育英儿童医院_神经病学_神经内科
通讯作者单位	第二临床医学院，附属第二医院、育英儿童医院_神经病学_神经内科
第一作者的第一单位	第二临床医学院，附属第二医院、育英儿童医院_神经病学_神经内科
推荐引用方式 GB/T 7714	Zhan, Zhenxiang,Xu, Tong,Xu, Ye,et al. Associations between computed tomography markers of cerebral small vessel disease and hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients[J]. FRONTIERS IN NEUROLOGY,2023,14.
APA	Zhan, Zhenxiang., Xu, Tong., Xu, Ye., Fu, Fangwang., Cheng, Zicheng., ... & Han, Zhao. (2023). Associations between computed tomography markers of cerebral small vessel disease and hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients. FRONTIERS IN NEUROLOGY, 14.
MLA	Zhan, Zhenxiang,et al."Associations between computed tomography markers of cerebral small vessel disease and hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients".FRONTIERS IN NEUROLOGY 14(2023).