Intracerebral hemorrhage after thrombolytic therapy in acute ischemic stroke patients with renal dysfunction

Tzu Hao Chao, Ting Chun Lin, Yao Shieh, Ting Yu Chang, Kuo Lun Hung, Chi Hung Liu, Tsong Hai Lee, Yeu Jhy Chang, Jiann Der Lee, Chien Hung Chang

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Abstract

Purpose: One complication of thrombolysis is intracranial hemorrhage (ICH). We investigated whether treatment with tissue plasminogen activator (t-PA) for ischemic infarction results in a higher risk of ICH in patients with kidney dysfunction, who are predisposed to treatment complications due to their bleeding tendency. Methods: A total of 297 patients given thrombolytic therapy for ischemic stroke were classified into 2 groups on the basis of their estimated renal glomerular filtration rate (eGFR). The outcome measures included the incidence of ICH and modified Rankin scale scores at 1 month and 1 year. Results: ICH was more common in the renal dysfunction group (23 vs. 12.5%). Nevertheless, multivariate logistic regression showed that the odds of ICH were not high in the group with low eGFR. Also, eGFR values <60 ml/min/1.73 m 2 did not predict the odds for functional dependence or death at 1 month and 1 year. Conclusion: After adjusting for confounding factors, the odds ratio for ICH was not higher in intravenous t-PA-treated stroke patients with renal dysfunction. A trend to the occurrence of ICH among these patients, however, was noted. Renal dysfunction does not predict the odds for functional dependence or death at 1 month and 1 year.

Original languageEnglish
Pages (from-to)316-321
Number of pages6
JournalEuropean Neurology
Volume70
Issue number5-6
DOIs
Publication statusPublished - Jan 1 2013

Keywords

  • Acute ischemic stroke
  • Intracerebral hemorrhage
  • Renal dysfunction
  • Thrombolytic therapy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Chao, T. H., Lin, T. C., Shieh, Y., Chang, T. Y., Hung, K. L., Liu, C. H., Lee, T. H., Chang, Y. J., Lee, J. D., & Chang, C. H. (2013). Intracerebral hemorrhage after thrombolytic therapy in acute ischemic stroke patients with renal dysfunction. European Neurology, 70(5-6), 316-321. https://doi.org/10.1159/000353296