title: Lower serum calcium level is associated with hemorrhagic transformation after thrombolysis.
abstract: OBJECTIVE
  We aim to investigate whether lower admission serum calcium levels are associated with hemorrhagic transformation (HT) after intravenous thrombolysis (IVT).
  
  
  METHODS
  A total of 362 patients treated with IVT was divided into 4 quartiles based on admission serum calcium levels (Q1[<2.16], Q2[2.16, 2.23], Q3[2.24, 2.31], and Q4[>2.31] mmol/L). HT was classified as hemorrhagic infarction and parenchymal hemorrhage. Logistic regression was applied to assess the association between serum calcium levels and the incidence of HT.
  
  
  RESULTS
  Compared with Q4, HT was more common in Q1 (odds ratio, 2.580; 95% CI, [1.258-5.292]; P=0.010), Q2 (odds ratio, 2.382; 95% CI, [1.163-4.877]; P=0.018), and Q3 (odds ratio, 2.293; 95% CI, [1.133-4.637]; P=0.021). Hemorrhagic infarction was more common in Q1 (P=0.037), and Q2 (P=0.018), compared with Q4, and parenchymal hemorrhage was more common in Q1 (P=0.029) than Q4.
  
  
  CONCLUSIONS
  Lower admission serum calcium level is independently associated with HT after IVT, and this hypothesis needs larger confirmatory trials.
authors: Department of Neurology, the 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Yang
authors: Y
authors: Guo
authors: Department of Neurology, the 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Shenqiang
authors: S
authors: Yan
authors: Department of Neurology, the 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Sheng
authors: S
authors: Zhang
authors: Department of Neurology, the 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Xiaocheng
authors: X
authors: Zhang
authors: Department of Neurology, the 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Qingmeng
authors: Q
authors: Chen
authors: Department of Neurology, the 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Keqin
authors: K
authors: Liu
authors: University of California-Los Angeles Stroke Center, Los Angeles, CA.
authors: David S
authors: DS
authors: Liebeskind
authors: Department of Neurology, the 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Min
authors: M
authors: Lou
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood*; D018450:Disease Progression; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000150:complications* / Q000628:therapy; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D002118:Calcium
keywords: serum-calcium-decreasing factor; stroke; thrombolytic therapy