A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis
Abstract Worldwide, stroke is a leading cause of long-term disability in adults. Alteplase is the only approved treatment for acute ischemic stroke (AIS) and results in an improvement in a third of treated patients. Most studies evaluated the post-alteplase haemorrhagic transformation of brain infar...
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Nature Portfolio
2024-11-01
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| author | Mohamed G. Zeinhom Sherihan Rezk Ahmed Ahmed Mohamed Kohail Islam Fathallah Mohamed Kamel ALshimaa Mahfouz Abdelrahman Omar M. AL-Nozha Mohamed Almoataz Tarek Youssif Omar Youssif Ahmed Mohamed Ali Daabis Hossam Mohamed Refat Ahmed Ahmed Mohamed Kamal Ebied Ahmed Elbassiouny Ahmed Zaki Omar Akl Ashfaq Shuaib Mohamed Ismaiel Asmaa Ibrahem Desouky Mostafa Ibrahem Mohamed Fouad Elsayed Khalil |
| author_facet | Mohamed G. Zeinhom Sherihan Rezk Ahmed Ahmed Mohamed Kohail Islam Fathallah Mohamed Kamel ALshimaa Mahfouz Abdelrahman Omar M. AL-Nozha Mohamed Almoataz Tarek Youssif Omar Youssif Ahmed Mohamed Ali Daabis Hossam Mohamed Refat Ahmed Ahmed Mohamed Kamal Ebied Ahmed Elbassiouny Ahmed Zaki Omar Akl Ashfaq Shuaib Mohamed Ismaiel Asmaa Ibrahem Desouky Mostafa Ibrahem Mohamed Fouad Elsayed Khalil |
| author_sort | Mohamed G. Zeinhom |
| collection | DOAJ |
| description | Abstract Worldwide, stroke is a leading cause of long-term disability in adults. Alteplase is the only approved treatment for acute ischemic stroke (AIS) and results in an improvement in a third of treated patients. Most studies evaluated the post-alteplase haemorrhagic transformation of brain infarction as a homogeneous entity but we evaluated the predictors of each subtype of haemorrhagic transformation of brain infarction. Our trial included 616 AIS alteplase-treated patients. We evaluated the ability of different risk factors, clinical presentation, and imaging features to predict different haemorrhagic transformation (HT) subtypes. HT was seen in 152 patients (24.7%), higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction, in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 (odds ratio [OR], 11.04; 95% CI, 9.81 to 12.70; P-value > 0.001) and type2 (OR, 11.89; 95% CI, 9.79 to 14.44; P-value > 0.001), while older age was also an independent predictor of parenchymal hematoma type1 (OR, 1.312; 95% CI, 1.245 to 1.912; P-value 0.02). In AIS patients treated with alteplase in Egypt and Saudi Arabia, higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction; in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 and 2, while older age was also an independent predictor of parenchymal hematoma type1. Trial registration: (clinicaltrials.gov NCT06337175), retrospectively registered on 29/03/2024. |
| format | Article |
| id | doaj-art-c057e650ba9849e8ae73d3a2ebf5703c |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-11-01 |
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| spelling | doaj-art-c057e650ba9849e8ae73d3a2ebf5703c2024-12-01T12:25:51ZengNature PortfolioScientific Reports2045-23222024-11-0114111310.1038/s41598-024-76189-0A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysisMohamed G. Zeinhom0Sherihan Rezk Ahmed1Ahmed Mohamed Kohail2Islam Fathallah Mohamed Kamel3ALshimaa Mahfouz Abdelrahman4Omar M. AL-Nozha5Mohamed Almoataz6Tarek Youssif Omar Youssif7Ahmed Mohamed Ali Daabis8Hossam Mohamed Refat9Ahmed Ahmed Mohamed Kamal Ebied10Ahmed Elbassiouny11Ahmed Zaki Omar Akl12Ashfaq Shuaib13Mohamed Ismaiel14Asmaa Ibrahem Desouky Mostafa Ibrahem15Mohamed Fouad Elsayed Khalil16Neurology Department, faculty of medicine, Kafr El-sheikh universityNeurology Department, faculty of medicine, Kafr El-sheikh universityNeurology Department, faculty of medicine, Al-Azhar universityNeurology Department, faculty of medicine, Tanta universityRadiology Department, faculty of medicine, ELminia universityMedicine Department, College of Medicine, Taibah UniversityNeurology Department, Saudi German hospitalNeurology Department, Burjeel medical city Abu DhabiNeurology Department, Burjeel Royal Hospital Al AinNeurology Department, Faculty of medicine Zagazig universityNeurology Department, Faculty of medicine Zagazig universityNeurology department, faculty of medicine, Ain shams universityNeurology department, faculty of medicine, Ain shams universityDivision of neurology, department of medicine, University of AlbertaNeurology Department, El-Sahel Teaching hospitalNeurology Department Al-Raml HospitalNeurology Department, Saudi German hospital MadinahAbstract Worldwide, stroke is a leading cause of long-term disability in adults. Alteplase is the only approved treatment for acute ischemic stroke (AIS) and results in an improvement in a third of treated patients. Most studies evaluated the post-alteplase haemorrhagic transformation of brain infarction as a homogeneous entity but we evaluated the predictors of each subtype of haemorrhagic transformation of brain infarction. Our trial included 616 AIS alteplase-treated patients. We evaluated the ability of different risk factors, clinical presentation, and imaging features to predict different haemorrhagic transformation (HT) subtypes. HT was seen in 152 patients (24.7%), higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction, in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 (odds ratio [OR], 11.04; 95% CI, 9.81 to 12.70; P-value > 0.001) and type2 (OR, 11.89; 95% CI, 9.79 to 14.44; P-value > 0.001), while older age was also an independent predictor of parenchymal hematoma type1 (OR, 1.312; 95% CI, 1.245 to 1.912; P-value 0.02). In AIS patients treated with alteplase in Egypt and Saudi Arabia, higher NIHSS, cardioembolic stroke and atrial fibrillation were independent predictors of all ECASS-based subtypes of hemorrhagic infarction; in addition, anterior-circulation stroke was an independent predictor of hemorrhagic infarction type 1 and 2, while older age was also an independent predictor of parenchymal hematoma type1. Trial registration: (clinicaltrials.gov NCT06337175), retrospectively registered on 29/03/2024.https://doi.org/10.1038/s41598-024-76189-0AlteplaseHemorrhagic infarctionEgyptSaudi ArabiaMiddle east |
| spellingShingle | Mohamed G. Zeinhom Sherihan Rezk Ahmed Ahmed Mohamed Kohail Islam Fathallah Mohamed Kamel ALshimaa Mahfouz Abdelrahman Omar M. AL-Nozha Mohamed Almoataz Tarek Youssif Omar Youssif Ahmed Mohamed Ali Daabis Hossam Mohamed Refat Ahmed Ahmed Mohamed Kamal Ebied Ahmed Elbassiouny Ahmed Zaki Omar Akl Ashfaq Shuaib Mohamed Ismaiel Asmaa Ibrahem Desouky Mostafa Ibrahem Mohamed Fouad Elsayed Khalil A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis Scientific Reports Alteplase Hemorrhagic infarction Egypt Saudi Arabia Middle east |
| title | A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis |
| title_full | A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis |
| title_fullStr | A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis |
| title_full_unstemmed | A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis |
| title_short | A multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis |
| title_sort | multicenter trial on the predictors of different subtypes of hemorrhagic infarction after thrombolysis |
| topic | Alteplase Hemorrhagic infarction Egypt Saudi Arabia Middle east |
| url | https://doi.org/10.1038/s41598-024-76189-0 |
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