title: Platelet derived growth factor-CC isoform is associated with hemorrhagic transformation in ischemic stroke patients treated with tissue plasminogen activator.
abstract: OBJECTIVE
  Platelet derived growth factor-CC (PDGF-CC) isoform is activated by tissue plasminogen activator (tPA) regulating blood brain barrier permeability after ischemia. We aimed to study the association of PDGF isoforms serum levels with hemorrhagic transformation (HT) and edema after thrombolytic treatment in ischemic stroke.
  
  
  METHODS
  We studied 129 patients with ischemic stroke treated with tPA within the first 4.5 h (h) from stroke onset. CT was performed on admission and at 24-36 h. On the 2nd CT, HT was classified according to ECASS II criteria, and severe brain edema was diagnosed if extensive swelling causing any shifting of the structures of the midline was detected. PDGF-AA, PDGF-AB, PDGF-BB and PDGF-CC serum levels were analyzed by ELISA on admission (before tPA bolus), at 24 and 72 h.
  
  
  RESULTS
  Patients who developed HT showed only higher levels of PDGF-CC isoform on admission and at 24 h (all p < 0.0001). In the multivariate analysis, PDGF-CC levels on admission (OR, 1.02; CI 95%, 1.00-1.04) and at 24 h (OR, 1.05; CI 95%, 1.02-1.08) were independently associated with HT after adjustment by confounding factors. On the other hand, patients with severe edema showed also higher levels of PDGF-CC on admission and at 24 h (p < 0.0001), but this statistical association was lost in the logistic regression analysis. PDGF-CC levels ≥ 175 ng/mL at 24 h predict the development of PH with a sensitivity of 90% and specificity of 88% (area under the curve 0.936; p < 0.0001).
  
  
  CONCLUSIONS
  Increased PDGF-CC levels after tPA treatment is associated with HT.
authors.affiliation: Clinical Neurosciences Research Laboratory, Neurovascular Area, Department of Neurology, Hospital Clínico Universitario, IDIS, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Rodríguez-González
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanco
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Yáñez
authors.forename: Octavio
authors.initials: O
authors.lastname: Moldes
authors.forename: José
authors.initials: J
authors.lastname: Castillo
authors.forename: Tomás
authors.initials: T
authors.lastname: Sobrino
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000139:chemically induced*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006801:Humans; D008222:Lymphokines / Q000097:blood*; D008297:Male; D010982:Platelet-Derived Growth Factor; D011446:Prospective Studies; D020033:Protein Isoforms / Q000097:blood; D020521:Stroke / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*
chemical_list: D005343:Fibrinolytic Agents; D008222:Lymphokines; D010982:Platelet-Derived Growth Factor; D020033:Protein Isoforms; C411423:platelet-derived growth factor C; D010959:Tissue Plasminogen Activator