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Titolo:
Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator - A secondary analysis of the European-Australasian Acute Stroke Study (ECASS II)
Autore:
Larrue, V; von Kummer, R; Muller, A; Bluhmki, E;
Indirizzi:
Univ Toulouse, Dept Neurol, Toulouse, France Univ Toulouse Toulouse France v Toulouse, Dept Neurol, Toulouse, France Univ Dresden, Dept Neuroradiol, Dresden, Germany Univ Dresden Dresden Germany resden, Dept Neuroradiol, Dresden, Germany Boehringer Ingelheim KG, D-6507 Ingelheim, Germany Boehringer Ingelheim KG Ingelheim Germany D-6507 6507 Ingelheim, Germany
Titolo Testata:
STROKE
fascicolo: 2, volume: 32, anno: 2001,
pagine: 438 - 441
SICI:
0039-2499(200102)32:2<438:RFFSHT>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
COOPERATIVE ACUTE STROKE; THROMBOLYTIC THERAPY;
Keywords:
intracerebral hemorrhage; risk factors; stroke, acute; thrombolytic therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Larrue, V Hop Rangueil, Dept Neurol, F-31403 Toulouse, France Hop Rangueil Toulouse France F-31403 F-31403 Toulouse, France
Citazione:
V. Larrue et al., "Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator - A secondary analysis of the European-Australasian Acute Stroke Study (ECASS II)", STROKE, 32(2), 2001, pp. 438-441

Abstract

Background and Purpose-Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) improves the outcome for ischemic stroke patients who can be treated within 3 hours of symptom onset. The efficacy of thrombolysis has been demonstrated despite an increased risk of seven hemorrhagic transformation (HT) in patients treated with rtPA. We performed an analysis of risk factors for severe HT in the second European-Australasian Acute Stroke Study (ECASS II). Methods-HTs were classified by using clinical and radiological criteria asfollows: hemorrhagic infarction (III), parenchymal hemorrhage (PH), and symptomatic intracranial hemorrhage (SICH). Potential risk factors fur HT were tested by stepwise logistic regression analysis, including rtPA-by-variable interactions. In addition, the distribution of bad outcome (modified Rankin score 5 to 6) at day 90 was stratified according to each category of HT. Results-PH and SIGH but not HI were associated with rtPA. Also, PH and SICH but not WI were more severe in rtPA-treated patients than in those receiving placebo. Risk factors for PII were rtPA, extent of parenchymal hypoattenuation on baseline CT, congestive heart failure, increasing age, and baseline systolic blood pressure. The risk of PH on rtPA was increased in older patients and in those who were treated with aspirin before thrombolysis. Risk factors for SIGH were rtPA, congestive heart failure, extent of parenchymal hypoattenuation, and increasing age. The risk of SIGH on rtPA was increased in patients who were treated with aspirin before thrombolysis. Conclusions-This secondary analysis of ECASS LI has confirmed the importance of the extent of hypoattenuation as a risk factor for severe HT. The findings also suggest that older patients and those who have used aspirin before stroke are at higher risk of a severe HT on rtPA.

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Documento generato il 28/11/20 alle ore 04:09:54