Does Prior Antiplatelet Treatment Increase the Risk of Hemorrhagic Transformation and Unfavorable Outcome on Day 90 after Intravenous Thrombolysis in Acute Ischemic Stroke Patients?

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• 作者：Siyan Chen ; MD^* ; ^{chensy0330@163.com" class="auth_mail" title="E-mail the corresponding author} ; Xia Lu ; MD^&dagger ; ; Wanli Zhang ; MD^* ; Zhao Han ; MD^&Dagger ; ; Wen Yang ; MD^§ ; ; Xuerong Huang ; MD^‖ ; Xiaoping Jin ; MD^¶ ; ; Zhimin Wang ; MD^¶ ; ; Haiyan Liang ; MD^# ; Weiwen Qiu ; MD^** ; Jianhua Cheng ; MD^* ; Bei Shao ; MD^*
• 关键词：Acute ischemic stroke ; prior antiplatelet therapy ; intravenous thrombolysis ; hemorrhagic transformation
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：25
• 期：6
• 页码：1366-1370
• 全文大小：98 K

文摘

The effect of prior antiplatelet (AP) therapy on the risk of hemorrhagic transformation (HT), and on functional outcomes of acute ischemic stroke (AIS) after intravenous thrombolysis (IVT), is not known. We performed a retrospective analysis to determine whether history of AP therapy is associated with post-thrombolysis HT and poor prognosis in AIS patients.

Methods

Data pertaining to 145 patients with AIS, who underwent IVT between October 2008 and January 2015, were analyzed. The patients were divided into 2 groups based on whether or not they had received prior AP therapy. Neurological outcomes at 24 hours and 3 months after IVT therapy were assessed. Intergroup difference in cost of treatment was also evaluated. A multivariate logistic regression model was used to identify independent predictors of post-thrombolysis HT.

Results

Among 145 patients, 23 (15.8%) had received prior AP therapy. On multivariate analyses, older age (odds ratio [OR]: 1.084; confidence interval [CI], 1.028-1.144) and prior AP therapy (OR: 3.318; CI, 1.172-9.398) were found to be independent predictors of HT.

Conclusion

In this study, prior AP therapy was independently associated with post-thrombolysis HT in AIS.