Association of atrial fibrillation with hemorrhagic transformation after intravenous thrombolysis in patients with ischemic stroke

doi:10.3785/j.issn.1008-9292.2019.06.04

J Zhejiang Univ (Med Sci)

2019, Vol. 48

Issue (3): 254-259 DOI: 10.3785/j.issn.1008-9292.2019.06.04

Association of atrial fibrillation with hemorrhagic transformation after intravenous thrombolysis in patients with ischemic stroke

TAO Anyang¹(

),WANG Zhimin^1,*(

),CHEN Hongfang²,XU Dongjuan³,HU Haifang⁴,WU Chenglong⁵,ZHANG Xiaoling⁶,MA Xiaodong⁷,WANG Yaxian⁸,HU Haitao⁹,LOU Min⁹,Improving In-hospital Stroke Service Utilisation (MISSION) in Zhejiang Province

1. Department of Neurology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
2. Department of Neurology, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
3. Department of Neurology, Dongyang People's Hospital, Dongyang 322100, Zhejiang Province, China
4. Department of Neurology, the First People's Hospital of Xiaoshan District, Hangzhou 311201, China
5. Department of Neurology, Shaoxing People's Hospital, Shaoxing 312000, Zhejiang Province, China
6. Department of Neurology, Jiaxing Second Hospital, Jiaxing 314000, Zhejiang Province, China
7. Department of Neurology, Haiyan People's Hospital, Haiyan 314300, Zhejiang Province, China
8. Department of Neurology, Huzhou Central Hospital, Huzhou 313003, Zhejiang Province, China
9. Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China

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Abstract

Objective: To investigate the association of atrial fibrillation (AF) with hemorrhagic transformation (HT) in patients with ischemic stroke treated by intravenous thrombolysis. Methods: Clinical data of 3272 patients treated by intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and December 2018 were retrospectively reviewed. Intracranial HT was defined as intracranial hemorrhage suggested by imaging examination 24 hours after intravenous thrombolysis. Patients were dichotomized into HT group (n=533) and non-HT group (n=2739). The association of AF and HT was analyzed by univariate analysis and binary logistic regression. Results: Compared with the non-HT group, the HT group were older, had longer onset to needle time (ONT), higher baseline National Institute of Health Stroke Scale (NIHSS) score, higher baseline glucose level, and higher AF rate (P < 0.05 or P < 0.01). Binary logistic regression analysis revealed that AF was independently associated with HT (OR=2.527, 95%CI:2.030-3.146, P < 0.01). Conclusion: AF is independently associated with the occurrence of HT in ischemic stroke patients treated with intravenous thrombolysis.

Key words： Stroke/therapy Brain ischemia/therapy Tissue plasminogen activator/therapeutic use Thrombolytic therapy Atrial fibrillation/etiology Intracranial hemorrhages Risk factors Retrospective studies

Received: 04 February 2019 Published: 04 September 2019

CLC:

R743

Corresponding Authors: WANG Zhimin E-mail: taoanyang1990@163.com;welson1980@163.com

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	Articles by authors
	TAO Anyang
	WANG Zhimin
	CHEN Hongfang
	XU Dongjuan
	HU Haifang
	WU Chenglong
	ZHANG Xiaoling
	MA Xiaodong
	WANG Yaxian
	HU Haitao
	LOU Min
	Improving In-hospital Stroke Service Utilisation (MISSION) in Zhejiang Province

Cite this article:

TAO Anyang, WANG Zhimin, CHEN Hongfang, XU Dongjuan, HU Haifang, WU Chenglong, ZHANG Xiaoling, MA Xiaodong, WANG Yaxian, HU Haitao, LOU Min, Improving In-hospital Stroke Service Utilisation (MISSION) in Zhejiang Province . Association of atrial fibrillation with hemorrhagic transformation after intravenous thrombolysis in patients with ischemic stroke. J Zhejiang Univ (Med Sci), 2019, 48(3): 254-259.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2019.06.04 OR http://www.zjujournals.com/med/Y2019/V48/I3/254

合并心房颤动对缺血性脑卒中患者静脉溶栓后颅内出血转化的影响

目的: 分析合并心房颤动对缺血性脑卒中患者静脉溶栓后颅内出血转化的影响。方法: 收集2017年6月至2018年12月浙江省71家医院3272例静脉溶栓患者的资料。静脉溶栓后24 h影像学检查提示颅内出血表现定义为颅内出血转化。根据患者是否出现出血转化分为出血转化组（533例）和未出血转化组（2739例），采用单因素和二元Logistic回归分析模型分析心房颤动是否与缺血性脑卒中患者静脉溶栓后出血转化相关。结果: 出血转化组患者的年龄、起病至溶栓时间、基线美国国立卫生研究院卒中量表（NIHSS）评分、基线血糖水平、心房颤动患者比例高于未出血转化组（P < 0.05或P < 0.01）。二元Logistic回归分析结果显示，心房颤动与缺血性脑卒中患者静脉溶栓后颅内出血转化的发生独立相关（OR=2.527，95%CI：2.030~3.146，P < 0.01）。结论: 心房颤动与缺血性脑卒中患者静脉溶栓后出血转化增加相关。

关键词： 卒中/治疗, 脑缺血/治疗, 组织型纤溶酶原激活物/治疗应用, 血栓溶解疗法, 心房颤动/病因学, 颅内出血, 危险因素, 回顾性研究

Tab 1 Baseline characteristics of ischemic stroke patients with and without atrial fibrillation

Tab 2 Characteristics of ischemic stroke patients with and without hemorrhagic transformation after intravenous thrombolysis

Tab 3 Binary logistic regression analysis for hemorrhagic transformation in ischemic stroke patients after intravenous thrombolysis


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