scholarly journals Hemorrhagic transformation after thrombolysis in acute ischemic stroke: a single-center crosssectional study

2021 ◽  
Author(s):  
Rônney Pinto Lopes ◽  
Matheus Gonçalves Maia ◽  
Lohana Santana Almeida da Silva ◽  
Luiza Ramos de Freitas ◽  
Natalia Trombini Mendes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
Cross Sectional Study ◽  
Hemorrhagic Transformation ◽  
Stroke Recurrence ◽  
Care Hospital ◽  
Cross Sectional ◽  
Standard Medical Treatment

Background: Intravenous thrombolysis is the standard medical treatment for acute ischemic stroke (AIS) within 4.5 hours of symptom onset, and symptomatic hemorrhagic transformation (sHT) is the most feared complication of this treatment. Objective: To describe the prevalence, risk factors, treatment and outcome of sHT. Design and setting: This is a retrospective cross-sectional study in a quaternary care hospital in Sao Paulo, Brazil. Methods: We reviewed 90 records of patients with AIS submitted to thrombolysis from March 2018 to February 2020. Evaluation of brain imaging after thrombolysis and the treatment initiated after detection of hemorrhage were made. Results: The overall prevalence of HT was 18.9% (n = 17, mean age 69.4±14.6 years, 58.8% males) and 8.9% (n = 8) of sHT. The most prevalent comorbidities were renal impairment (82%), hypertension (76.4%), diabetes mellitus (35.2%), atrial fibrillation (35.2%) and smoking (35.2%). The median baseline NIHSS score was 17. The most prevalent radiological classification of post-thrombolysis HT was class 2 (41.1%) from the Heidelberg Bleeding Classification. Cryoprecipitate and tranexamic acid were administered in 11.8% (n = 2). The mortality rate for HT was 35.3% (n = 6). Antiplatelet or anticoagulant therapy was initiated after a mean of 24.6 days from HT diagnosis and there was no stroke recurrence at 90 days. Conclusion: We showed a prevalence of sHT and related risk factors aligned with other studies, but with high mortality rates, despite being a stroke service. The late initiation of antiplatelets or anticoagulants did not lead to stroke recurrence at 90 days.

scholarly journals Mutually Risk Roles of Oral Cleanliness and Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke: A Cross-Sectional Study

2020 ◽  
Author(s):  
Xiaohua Yang ◽  
Huijuan Chen ◽  
Wanling Yang ◽  
Bin Deng ◽  
Jialing Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Dental Caries ◽  
Acute Ischemic Stroke ◽  
Oral Hygiene ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Stroke Patients ◽  
Cross Sectional

Abstract Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.

scholarly journals Carotid artery intima-media thickness in patients with acute ischemic stroke and its correlation with risk factors for atherosclerosis and/or stroke

2014 ◽  
Vol 6 (1) ◽  
pp. 22-27
Author(s):  
Shovan Kumar Das ◽  
Amit Sarkar ◽  
Subhraprakash Pramanik ◽  
Mitabha Bandyopadhyay ◽  
Koushik Mondal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Intima Media Thickness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Media Thickness ◽  
Matched Study ◽  
Atherosclerotic Risk Factors

Introduction: Stroke is the second leading cause of mortality worldwide. Ischemic stroke is  more prevalent than hemorrhagic stroke and atherosclerosis is the major cause of ischemic stroke. The increased carotid artery intima-media thickness (CIMT) is considered to be useful indicator of early atherosclerosis. So, this study was aimed to correlate the relationship between atherosclerotic risk factors and intima-media thickness of carotid artery in patients with acute ischemic stroke. Material and Methods: In this cross-sectional study, 100 consecutive patients of acute ischemic stroke and 50 healthy relatives of patients as control were studied for presence of atherosclerotic risk factors and carotid artery intima?media thickness by B-mode Doppler ultrasonography.Results: In this age and sex matched study, higher CIMT measurement was found among patients of acute ischemic stroke than healthy controls (0.849 ± 0.196 vs 0.602 ± 0.092; p < 0.001). The CIMT was well correlated with smoking (Beta = 0.295; t = 5.728; 95% CI 0.088 to 0.181; p < 0.001); hypertension (Beta = 0.387; t = 6.518; CI 0.112 to 0.209; p < 0.001); di abetes (Beta = 0.237; t = 4.848; CI 0.074 to 0.175; p < 0.001); hypercholesterolemia (Beta = 0.292; t = 5.840; CI 0.096 to 0.195; p < 0.001), but not with age (p = 0.153). The CIMT was also found to be higher among acute ischemic stroke patients who were smoker, hypertensive, diabetic and hypercholesterolemic than non?smoker, normotensive, non-diabetic and normo-cholesterolemic respectively. Conclusion: The CIMT being indicator of atherosclerosis can be used as future predictor of ischemic stroke. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10301 Asian Journal of Medical Sciences Vol.6(1) 2015 22-27

scholarly journals Predictors of Hemorrhagic Transformation in Patients Receiving r-tPA

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
T K Alosh ◽  
H Aref ◽  
M K Elewa ◽  
A A Mohamed
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
Hemorrhagic Transformation ◽  
University Hospital ◽  
Tissue Type ◽  
P Value ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Hospital Patients

Abstract Background intravenous recombinant tissue-type plasminogen activator (r-tPA) is a proven intervention for acute ischemic stroke patients. The rationale behind the use of r-tPA in ischemic stroke is breaking down the clot and recanalization of the occluded blood vessels. The restoration of blood vessel patency is meaningful only if the brain tissue of the ischemic area is still viable. Intravenous thrombolysis showed moderate benefit upon administration between three and four and half hours from stroke onset. Aim of the Work assess the risk factors that lead to occurrence of hemorrhagic transformation in patients with acute ischemic stroke received intravenous thrombolytic during their hospital stay. Patients and Methods This is a retrospective cross-sectional observational study conducted in Ain Shams University hospital and Ain Shams University Specialized hospital. 200 patients were included in the study. All were in-patients, admitted in the stroke unit either in Ain Shams University hospital or Ain Shams University Specialized hospital. Patients were diagnosed by neurological history, clinical examination and radiological investigations (CT scan with or without MRI brain stroke protocol). The diagnosis of stroke must be made by a neurologist. Results there was statistically significant association found between hemorrhagic transformation and smoking and also onset of stroke while no statistically significant association found with BP during injection and RBS. Conclusion there was highly statistically significant associaton between hemorrhagic transformation and onset of stroke with p-value = 0.006 and OR (95% CI) 5.92 (1.656–21.165) while there was statistically significant association found with smoking with p-value = 0.012 and OR (95% CI) 2.424 (1.214–4.844).

scholarly journals Oral contraceptive among risk factors for women with ischemic stroke

2021 ◽  
Vol 12 (1) ◽  
pp. 548
Author(s):  
Carla S. PALUDO ◽  
Amanda SACHETTI ◽  
Maiara S. PAIXÃO
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Oral Contraceptive ◽  
Oral Contraceptives ◽  
Contraceptive Use ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Northern Region ◽  
Cross Sectional ◽  
The Mean

Objective: To evaluate the frequency of use of oral contraceptives and other risk factors among women with ischemic stroke seen at a hospital in the northern region of the state of Rio Grande do Sul. Methods: Prospective, cross-sectional study. The population was characterized by patients admitted with a diagnosis of ischemic stroke during a period from March to August 2019 and the sample by female patients found in the population. The data were collected through an individual interview using a questionnaire developed by the researchers and tabulated for further analysis. All analyzes were performed using the statistical program Bioestat 5.0, considering p = 0.05. Results: In the characterization of the sample, an average age of 68.2 years was observed. The occurrence of gender was 52.4% for women. The mean hospital stay was 12.2 ± 8.91 days. Outcome of hospital discharge was 89.1%. The mean value of body mass index was 25 ± 4.89 kg / m², with an average of 27.4 kg / m² in patients who used oral contraceptives and 25.23 kg / m² in patients who did not use oral contraceptives. The sample had a 34.5%incidence of oral contraceptive use. The average age of those who used oral contraceptives was 62.4 years and of the patients who did not use it was 70.3 years. Conclusion: The study showed a high use of oral contraceptives in the sample, with percentage values very close to other factors evaluated, thus showing itself as a probable risk factor for the development of ischemic stroke.

scholarly journals HUBUNGAN ANTARA PERUBAHAN KADAR HS-CRP DENGAN FUNGSI KOGNITIF PADA STROKE ISKEMIK

2018 ◽  
Vol 35 (2) ◽  
Author(s):  
Betsi Sumanti ◽  
Hexanto Hexanto ◽  
Widiastuti Widiastuti
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Function ◽  
Acute Ischemic Stroke ◽  
Inflammatory Marker ◽  
Cross Sectional Study ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Hs Crp ◽  
Relationship Of

   ASSOCIATION BETWEEN ALTERED HS-CRP LEVELS AND  COGNITIVE FUNCTION OF ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: The incidence of cognitive impairment in acute ischemic stroke patients is increasing. The mechanism of the inflammatory effect, such as  elevated hs-CRP level, a  non-specific inflammatory marker  sensitive to chronic inflammation due to hypoperfusion as well other vascular risk, is thought to have an effect on cognitive function.Aims: To determine the relationship of cognitive function changes in acute phase of ischemic stroke with hs-CRP level changes on day 3 and day 7 after onset.Methods: This was a cross sectional study of 31 first-timer ischemic stroke patients who met inclusion and exclusion criteria. The level of hs-CRP was checked on the 3rd day and 7th day after onset, while MoCA-Ina was assessed on the 7th day after onset. Cognitive disturbance was considered if MoCA <26. Analyses was done using SPSS 2.0Results: The average onset of day 3 Hs-CRP concentration was 0.66 (0.12-16.67)mg/dl and the onset of day 7 was 5.455 (0.14-17.34)mg/dl. The mean change of hs-CRP level between 3 day and 7 day after onset was -0,16 (-3.32-4.95). There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Discussion: There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Keyword: Acute ischemic stroke, hs-CRP, MoCA-Ina scoresABSTRAKPendahuluan: Insidens penurunan fungsi kognitif pada pasien stroke iskemik akut semakin meningkat. Hal ini diduga dipengaruhi oleh mekanisme efek inflamasi, meliputi peningkatan kadar high sensitive-C reactive protein (hs-CRP), salah satu penanda inflamasi non-spesifik yang sangat sensitif pada inflamasi kronis, akibat hipoperfusi maupun karena risiko vaskuler lainnya.Tujuan: Mengetahui hubungan perubahan fungsi kognitif pasien stroke iskemik fase akut dengan perubahan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan.Metode: Studi potong lintang terhadap penderita stroke iskemik pertama kali yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pemeriksaan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan dan MoCA-Ina pada hari ke-7 setelah awitan. Fungsi kognitif dinyatakan terganggu jika MoCA-Ina <26. Analisis data menggunakan program SPSS 22.0.Hasil: Didapatkan rerata kadar Hs-CRP hari ke-3 setelah awitan adalah 0,66 (0,12-16,67)mg/dl dan hari ke-7 setelah awitan adalah 5,455 (0,14-17,34)mg/dl. Dengan rerata perubahan kadar hs-CRP awitan hari ke-3 dan awitan hari ke-7 adalah -0,16 (-3,32-4,95). Didapatkan hubungan yang bermakna antara perubahan kadar hs-CRP hari ke-3 setelah awitan dan hari ke-7 setelah awitan dengan fungsi kognitif pasien stroke iskemik akut.Kesimpulan: Didapatkan hubungan yang bermakna antara peningkatan kadar hs-CRP pada hari ke-7 dan kadar hari ke-3 dengan fungsi kognitif pasien stroke iskemik akut.Kata kunci: hs-CRP, MoCA-Ina, stroke iskemik akut 

scholarly journals KADAR FIBRIN MONOMER DAN UKURAN INFARK DI STROK ISKEMIK AKUT

2016 ◽  
Vol 20 (3) ◽  
pp. 171
Author(s):  
Ani Kartini ◽  
Mansyur Arif ◽  
Hardjoeno Hardjoeno
Keyword(s):  
Ischemic Stroke ◽  
Infarct Size ◽  
Acute Ischemic Stroke ◽  
Thrombus Formation ◽  
Infarct Volume ◽  
Cross Sectional Study ◽  
Cerebral Infarct ◽  
Cross Sectional ◽  
Fibrin Monomer ◽  
Significant Difference

Coagulation activation and thrombosis frequently exist in ischemic stroke, thrombus formation can be detected early by the presence of fibrin monomer. The purpose of this study was to know the correlation of fibrin monomer level with cerebral infarct size in acute ischemic stroke patients. This was a cross sectional study with a total of 39 samples. The fibrin monomer level was determined by immunoturbidimetry method using STA-Compact and the measurement of the infarct size was done by CT scan of the head using Broderick formula. The results of this study showed that the median level of fibrin monomer in acute ischemic stroke with nonlacunar infarct type and lacunar infarct type were 14.46 μg/mL and 4.29 μg/mL, respectively. Mann-Whitney test showed there was a significant difference of fibrin monomer levels between nonlacunar infarct type and the lacunar type, p=0.000. The cut-off point analysis result of the fibrin monomer level was 5.96 μg/mL with a sensitivity of 88.9% and specificity of 76.4%, respectively. Spearman correlation test showed that fibrin monomer level was positively correlated with cerebral infarct volume in acute ischemic stroke (r=0.56, p=0.000). Based on this study, it can be concluded that fibrin monomer level can be used as a marker to predict the type of cerebral infarct and volume of acute ischemic stroke as well.

scholarly journals Cross-sectional Study on MyocardialInfarction in Young Adults in an EmergencyDepartment of a Rural Tertiary Care Hospital, Davanagere,Karnataka, India

2021 ◽  
Author(s):  
CH Karthik Reddy ◽  
Mahesh Krishnamurthy ◽  
Ashray Vasanthapuram ◽  
Girish Narayan ◽  
SS Narendra
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Young Adults ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vessel Disease

Introduction: The incidence of Acute Coronary Syndrome (ACS) in the young has been increasing globally. Research in this population has been limited in developed countries or urban areas in developing countries. Identifying the various epidemiologic features in this age group is crucial to understand the disease. Aim: To describe the clinical characteristics of young adults presenting with ACS in a rural tertiary care hospital. Materials and Methods: This cross-sectional study included 50 patients diagnosed with ACS. Data were collected from consecutive patients between the ages of 18 to 45 years diagnosed with ACS between January 2014 to January 2015 in the Emergency Medicine Department of a tertiary care hospital in Davanagere, India. Data were collected on demographic characteristics, risk factors, laboratory tests, and angiographic findings. Range, mean and percentages were calculated for continuous and categorical variables, respectively. A 95% confidence intervals were calculated for all variables. Results: The mean age was 38.1±5.8 years with male preponderance 46 (92%). Risk factors were smoking 36 (72%), diabetes 17 (34%), hypertension 6 (12%) and Body Mass Index (BMI) >23 kg/m2, 36 (72%). Anterior Wall Myocardial Infarction (AWMI) was observed in 35 (70%) of subjects with angiography revealing Single Vessel Disease (SVD) 28 (56%), Double Vessel Disease (DVD) 5 (10%), Triple Vessel Disease (TVD) 3 (6%) and Myocardial Infarction with Non-Obstructive Coronary Artery Disease (MINOCA) 11 (22%). Three patients died during their course of treatment before initiating an interventional procedure. Conclusion: Smoking, diabetes mellitus and elevated BMI are associated with ACS among young patients. Interventions targeting these risk factors among younger individuals should be developed.

Sign in / Sign up

Export Citation Format

Share Document