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Thrombolytic-Related Asymptomatic Hemorrhagic Transformation Does Not Deteriorate Clinical Outcome: Data from TIMS in China.

Jia W, Liao X, Pan Y, Wang Y, Cui T, Zhou L, Wang Y, TIMS-CHINA investigato - PLoS ONE (2015)

Bottom Line: Logistic regression analysis was used to evaluate the effects of AHT on a short-term and long-term clinical outcome. 904 of all 1440 patients in TIMS-China registry were enrolled. 89 (9.6%) patients presented with AHT after thrombolysis within 24-36 h.No significant difference was found on the odds of 7-day (95% CI:0.692 (0.218-2.195), (P = 0.532) or 90-day mortalities (95% CI:0.548 (0.237-1.268), P = 0.160) and modified Rankin Score(0-1) at 90-day (95% CI:0.798 (0.460-1.386), P = 0.423) or modified Rankin Score(0-2) at 90-day (95% CI:0.732 (0.429-1.253), P = 0.116) or modified Rankin Score(5-6) at 90-day (95% CI:0.375 (0.169-1.830), P = 0.116) between two groups.Thrombolytic-related AHT does not deteriorate short-term and long-term clinical outcome.

View Article: PubMed Central - PubMed

Affiliation: Center of Stroke, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

ABSTRACT

Objective: It has been unclear whether thrombolytic-related asymptomatic hemorrhagic transformation (AHT) affects the clinical outcome. To answer this question, we examined whether thrombolytic-related AHT affect short-term and long-term clinical outcome.

Methods: All data were collected from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) registry. The patients were diagnosed as having AHT group and non- hemorrhagic transformation (HT) group based on clinical and imaging data. The patients with symptomatic hemorrhagic transformation were excluded from this study. Thrombolytic-related AHT was defined according to European-Australasian Acute Stroke Study (ECASS) II criteria. 90-day functional outcome, 7-day National Institutes of Health Stroke Scale (NIHSS) score, 7-day and 90-day mortalities were compared between two groups. Logistic regression analysis was used to evaluate the effects of AHT on a short-term and long-term clinical outcome.

Results: 904 of all 1440 patients in TIMS-China registry were enrolled. 89 (9.6%) patients presented with AHT after thrombolysis within 24-36 h. These patients with AHT were more likely to be elder age, cardioembolic subtype, and to have higher National Institutes of Health Stroke Scale score before thrombolysis than patients without AHT. No significant difference was found on the odds of 7-day (95% CI:0.692 (0.218-2.195), (P = 0.532) or 90-day mortalities (95% CI:0.548 (0.237-1.268), P = 0.160) and modified Rankin Score(0-1) at 90-day (95% CI:0.798 (0.460-1.386), P = 0.423) or modified Rankin Score(0-2) at 90-day (95% CI:0.732 (0.429-1.253), P = 0.116) or modified Rankin Score(5-6) at 90-day (95% CI:0.375 (0.169-1.830), P = 0.116) between two groups.

Conclusions: Thrombolytic-related AHT does not deteriorate short-term and long-term clinical outcome.

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Related in: MedlinePlus

Comparison of function in different subtype of AHT at 7-day and at 90-day in TIMS-china.AHT: asymptomatic hemorrhagic transformation; mRS, modified Rankin Scale; HI1:hemorrhagic infarcts type 1; HI2: hemorrhagic infarcts type 2; PH1: parenchymal hematomas type 1; PH2: parenchymal hematomas type 2.
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pone.0142381.g002: Comparison of function in different subtype of AHT at 7-day and at 90-day in TIMS-china.AHT: asymptomatic hemorrhagic transformation; mRS, modified Rankin Scale; HI1:hemorrhagic infarcts type 1; HI2: hemorrhagic infarcts type 2; PH1: parenchymal hematomas type 1; PH2: parenchymal hematomas type 2.

Mentions: The proportion of poor outcome in patients with AHT was 13.48% at 3 months after a stroke onset and the patients with non-HT was 11.04%. AHT deteriorated clinical outcomes of 90-day of follow-up (mRS score (0–1 grade) and mRS score (0–2) in patients after thrombolysis when we analyze the data without any adjustment for covariates. After adjustment for baseline relevant factors, no significant difference was found on the odds of 7-day (95% CI:0.692 (0.218–2.195), (P = 0.532) or 90-day mortalities (95% CI:0.548 (0.237–1.268), P = 0.160) and modified Rankin score(0–1) at 90-day (95% CI:0.798 (0.460–1.386), P = 0.423) or modified Rankin score(0–2) at 90-day (95% CI:0.732 (0.429–1.253), P = 0.116) or modified Rankin score(5–6) at 90-day (95% CI:0.375 (0.169–1.830), P = 0.116) between two groups (Table 2). In AHT subgroup analysis, there was a more favorable clinical outcome in HI1and HI2 subgroups than PH1 and PH2 subgroups (Fig 2).


Thrombolytic-Related Asymptomatic Hemorrhagic Transformation Does Not Deteriorate Clinical Outcome: Data from TIMS in China.

Jia W, Liao X, Pan Y, Wang Y, Cui T, Zhou L, Wang Y, TIMS-CHINA investigato - PLoS ONE (2015)

Comparison of function in different subtype of AHT at 7-day and at 90-day in TIMS-china.AHT: asymptomatic hemorrhagic transformation; mRS, modified Rankin Scale; HI1:hemorrhagic infarcts type 1; HI2: hemorrhagic infarcts type 2; PH1: parenchymal hematomas type 1; PH2: parenchymal hematomas type 2.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664552&req=5

pone.0142381.g002: Comparison of function in different subtype of AHT at 7-day and at 90-day in TIMS-china.AHT: asymptomatic hemorrhagic transformation; mRS, modified Rankin Scale; HI1:hemorrhagic infarcts type 1; HI2: hemorrhagic infarcts type 2; PH1: parenchymal hematomas type 1; PH2: parenchymal hematomas type 2.
Mentions: The proportion of poor outcome in patients with AHT was 13.48% at 3 months after a stroke onset and the patients with non-HT was 11.04%. AHT deteriorated clinical outcomes of 90-day of follow-up (mRS score (0–1 grade) and mRS score (0–2) in patients after thrombolysis when we analyze the data without any adjustment for covariates. After adjustment for baseline relevant factors, no significant difference was found on the odds of 7-day (95% CI:0.692 (0.218–2.195), (P = 0.532) or 90-day mortalities (95% CI:0.548 (0.237–1.268), P = 0.160) and modified Rankin score(0–1) at 90-day (95% CI:0.798 (0.460–1.386), P = 0.423) or modified Rankin score(0–2) at 90-day (95% CI:0.732 (0.429–1.253), P = 0.116) or modified Rankin score(5–6) at 90-day (95% CI:0.375 (0.169–1.830), P = 0.116) between two groups (Table 2). In AHT subgroup analysis, there was a more favorable clinical outcome in HI1and HI2 subgroups than PH1 and PH2 subgroups (Fig 2).

Bottom Line: Logistic regression analysis was used to evaluate the effects of AHT on a short-term and long-term clinical outcome. 904 of all 1440 patients in TIMS-China registry were enrolled. 89 (9.6%) patients presented with AHT after thrombolysis within 24-36 h.No significant difference was found on the odds of 7-day (95% CI:0.692 (0.218-2.195), (P = 0.532) or 90-day mortalities (95% CI:0.548 (0.237-1.268), P = 0.160) and modified Rankin Score(0-1) at 90-day (95% CI:0.798 (0.460-1.386), P = 0.423) or modified Rankin Score(0-2) at 90-day (95% CI:0.732 (0.429-1.253), P = 0.116) or modified Rankin Score(5-6) at 90-day (95% CI:0.375 (0.169-1.830), P = 0.116) between two groups.Thrombolytic-related AHT does not deteriorate short-term and long-term clinical outcome.

View Article: PubMed Central - PubMed

Affiliation: Center of Stroke, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

ABSTRACT

Objective: It has been unclear whether thrombolytic-related asymptomatic hemorrhagic transformation (AHT) affects the clinical outcome. To answer this question, we examined whether thrombolytic-related AHT affect short-term and long-term clinical outcome.

Methods: All data were collected from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) registry. The patients were diagnosed as having AHT group and non- hemorrhagic transformation (HT) group based on clinical and imaging data. The patients with symptomatic hemorrhagic transformation were excluded from this study. Thrombolytic-related AHT was defined according to European-Australasian Acute Stroke Study (ECASS) II criteria. 90-day functional outcome, 7-day National Institutes of Health Stroke Scale (NIHSS) score, 7-day and 90-day mortalities were compared between two groups. Logistic regression analysis was used to evaluate the effects of AHT on a short-term and long-term clinical outcome.

Results: 904 of all 1440 patients in TIMS-China registry were enrolled. 89 (9.6%) patients presented with AHT after thrombolysis within 24-36 h. These patients with AHT were more likely to be elder age, cardioembolic subtype, and to have higher National Institutes of Health Stroke Scale score before thrombolysis than patients without AHT. No significant difference was found on the odds of 7-day (95% CI:0.692 (0.218-2.195), (P = 0.532) or 90-day mortalities (95% CI:0.548 (0.237-1.268), P = 0.160) and modified Rankin Score(0-1) at 90-day (95% CI:0.798 (0.460-1.386), P = 0.423) or modified Rankin Score(0-2) at 90-day (95% CI:0.732 (0.429-1.253), P = 0.116) or modified Rankin Score(5-6) at 90-day (95% CI:0.375 (0.169-1.830), P = 0.116) between two groups.

Conclusions: Thrombolytic-related AHT does not deteriorate short-term and long-term clinical outcome.

Show MeSH
Related in: MedlinePlus