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Year : 2018  |  Volume : 131  |  Issue : 14  |  Page : 1639-1644

Glomerular Filtration Rate is Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients without Thrombolytic Therapy

1 Department of Neurology, First Affiliated Hospital of Chongqing Medical University; Chongqing Key Laboratory of Neurobiology, Chongqing 400016, China
2 Department of Neurology, Chengdu 363 Hospital of Southwest Medical University, Chengdu, Sichuan 610000, China

Correspondence Address:
Dr. Guang-Qin Li
Department of Neurology, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0366-6999.235873

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Background: Whether there is a relationship between glomerular filtration rate (GFR) and hemorrhagic transformation (HT) after acute ischemic stroke (AIS) is still under debate. The aim of our study was to determine whether the GFR level is a predictor of HT in AIS patients without thrombolytic therapy (TT). Methods: Consecutive AIS patients without TT were included in this prospective study from January 2014 to December 2016 in the First Affiliated Hospital of Chongqing Medical University. We divided them into two groups (HT and non-HT group) and meticulously collected baseline characteristics and laboratory and imaging data of interested individuals. Multivariate regression analysis was performed to assess the correlation between GFR and HT in stroke patients without TT. Results: Among 426 consecutive patients, 74 (17.3%) presented HT (mean age: 65 ± 12 years, number of male patients: 47) on the follow-up scans. In multivariate regression analysis, HT was significantly associated with low GFR (odds ratio [OR] = 3.708, confidence interval [CI] = 1.326–10.693, P = 0.013), atrial fibrillation (AF; OR = 2.444, CI = 1.087–5.356, P = 0.027), large cerebral infarction (OR = 2.583, CI = 1.236–5.262, P = 0.010), and hypoalbuminemia (HA; OR = 4.814, CI = 1.054–22.153, P = 0.037) for AIS patients without TT. Conclusions: The present study strongly showed that lower GFR is an independently predictor of HT; in addition, large infarct volume, AF, and HA are also important risks of HT for AIS patients without TT, which offered a practical information that risk factors should be paid attention or eliminated to prevent HT for stroke patients though the level of evidence seems to be unstable.


 Abstract in Chinese





结果:426例纳入的患者中共74例(17.3%)在影像学随访中出现出血转化(平均年龄65±12岁,男性47例)。在多元回归分析中非溶栓性缺血性卒中患者出血转化与低肾小球滤过率(OR=3.708, CI=1.326~10.693,P=0.013),房颤(OR=2.444, CI=1.087~5.356,P =0.027),大面积脑梗死(OR=2.583, CI=1.236~5.262,P =0.010)及低蛋白血症(OR=4.814, CI=1.054~22.153,P =0.037)存在显著相关性。


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