Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis

Chun Ming Yang, Chien Ling Hung, Hui Chen Su, Huey Juan Lin, Chih Hung Chen, Chou Ching Lin, Han Hwa Hu, Sheng Hsiang Lin, Pi Shan Sung

研究成果: 雜誌貢獻文章

3 引文 (Scopus)

摘要

Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3% showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6% - 7.2% based on different definitions, and overall, 24.9% of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95% C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.
原文英語
文章編號e0196505
期刊PLoS One
13
發行號5
DOIs
出版狀態已發佈 - 五月 1 2018

指紋

Leukoaraiosis
Intracranial Hemorrhages
stroke
hemorrhage
Brain
Stroke
Cerebral Hemorrhage
Computerized tomography
Tissue Plasminogen Activator
Magnetic resonance imaging
Imaging techniques
rating scales
t-plasminogen activator
brain
Hemorrhage
computed tomography
pretreatment
image analysis
Population
Registries

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

引用此文

Yang, C. M., Hung, C. L., Su, H. C., Lin, H. J., Chen, C. H., Lin, C. C., ... Sung, P. S. (2018). Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis. PLoS One, 13(5), [e0196505]. https://doi.org/10.1371/journal.pone.0196505

Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis. / Yang, Chun Ming; Hung, Chien Ling; Su, Hui Chen; Lin, Huey Juan; Chen, Chih Hung; Lin, Chou Ching; Hu, Han Hwa; Lin, Sheng Hsiang; Sung, Pi Shan.

於: PLoS One, 卷 13, 編號 5, e0196505, 01.05.2018.

研究成果: 雜誌貢獻文章

Yang, CM, Hung, CL, Su, HC, Lin, HJ, Chen, CH, Lin, CC, Hu, HH, Lin, SH & Sung, PS 2018, 'Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis', PLoS One, 卷 13, 編號 5, e0196505. https://doi.org/10.1371/journal.pone.0196505
Yang, Chun Ming ; Hung, Chien Ling ; Su, Hui Chen ; Lin, Huey Juan ; Chen, Chih Hung ; Lin, Chou Ching ; Hu, Han Hwa ; Lin, Sheng Hsiang ; Sung, Pi Shan. / Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis. 於: PLoS One. 2018 ; 卷 13, 編號 5.
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title = "Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis",
abstract = "Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3{\%} showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6{\%} - 7.2{\%} based on different definitions, and overall, 24.9{\%} of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95{\%} C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.",
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AU - Chen, Chih Hung

AU - Lin, Chou Ching

AU - Hu, Han Hwa

AU - Lin, Sheng Hsiang

AU - Sung, Pi Shan

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N2 - Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3% showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6% - 7.2% based on different definitions, and overall, 24.9% of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95% C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.

AB - Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3% showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6% - 7.2% based on different definitions, and overall, 24.9% of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95% C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.

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