title: Prediction of hemorrhagic transformation in acute ischaemic stroke by micro- and macroalbuminuria after intravenous thrombolysis.
abstract: OBJECTIVE
  Hemorrhagic transformation (HT) is one of the most problematic complications to arise from intravenous thrombolysis (IVT). This study was conducted to assess whether micro- and macroalbuminuria could be associated with HT after IVT in patients with acute ischaemic stroke, and to investigate whether the value of urinary albumin-to-creatinine ratios would correlate with the degree of HT.
  
  
  METHODS
  This was a retrospective study of stroke patients who had undergone IVT within 3 h of symptom onset. Albuminuria assessment was based on random morning spot urine collection with patients in a fasting state, the first morning after IVT. Multiple logistic regression analysis was used to evaluate whether the presence of micro- and macroalbuminuria might be independent predictors of HT.
  
  
  RESULTS
  One-hundred and fifty-four patients were included in the study. Fifty-one patients had HT. The presence of micro- or macroalbuminuria was associated with HT after adjustment for variables with clinical significance (adjusting for age, atrial fibrillation, platelet counts, baseline National Institutes of Health Stroke Scale score, hypertension and diabetes mellitus; odds ratio, 2.542; 95% confidence interval, 1.106-5.841; P = 0.028). There were significant relationships between the presence of micro- and macroalbuminuria and types of HT.
  
  
  CONCLUSIONS
  In conclusion, the results of this study suggest that the presence of micro- and macroalbuminuria after IVT could be a predictor of severe HT in patients with acute ischaemic stroke.
authors.affiliation: Department of Neurology, Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: B-H
authors.initials: BH
authors.lastname: Cho
authors.forename: J-T
authors.initials: JT
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Chang
authors.forename: K-H
authors.initials: KH
authors.lastname: Choi
authors.forename: M-S
authors.initials: MS
authors.lastname: Park
authors.forename: K-H
authors.initials: KH
authors.lastname: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000150:complications*; D019540:Area Under Curve; D002545:Brain Ischemia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020300:Intracranial Hemorrhages / Q000188:drug therapy / Q000209:etiology*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator
keywords: acute ischaemic stroke; hemorrhagic transformation; intravenous thrombolysis; macroalbuminuria; microalbuminuria; parenchymal hematoma