title: Does Prior Antiplatelet Treatment Increase the Risk of Hemorrhagic Transformation and Unfavorable Outcome on Day 90 after Intravenous Thrombolysis in Acute Ischemic Stroke Patients?
abstract: BACKGROUND
  The effect of prior antiplatelet (AP) therapy on the risk of hemorrhagic transformation (HT), and on functional outcomes of acute ischemic stroke (AIS) after intravenous thrombolysis (IVT), is not known. We performed a retrospective analysis to determine whether history of AP therapy is associated with post-thrombolysis HT and poor prognosis in AIS patients.
  
  
  METHODS
  Data pertaining to 145 patients with AIS, who underwent IVT between October 2008 and January 2015, were analyzed. The patients were divided into 2 groups based on whether or not they had received prior AP therapy. Neurological outcomes at 24 hours and 3 months after IVT therapy were assessed. Intergroup difference in cost of treatment was also evaluated. A multivariate logistic regression model was used to identify independent predictors of post-thrombolysis HT.
  
  
  RESULTS
  Among 145 patients, 23 (15.8%) had received prior AP therapy. On multivariate analyses, older age (odds ratio [OR]: 1.084; confidence interval [CI], 1.028-1.144) and prior AP therapy (OR: 3.318; CI, 1.172-9.398) were found to be independent predictors of HT.
  
  
  CONCLUSIONS
  In this study, prior AP therapy was independently associated with post-thrombolysis HT in AIS.
authors.affiliation: Departmentof Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: chensy0330@163.com.
authors.forename: Siyan
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Neurology, First People's Hospital of Jiaxing, Jianxing, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Lu
authors.affiliation: Departmentof Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Wanli
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Han
authors.affiliation: Department of Neurology, Jinhua Central Hospital, Jinhua, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Yang
authors.affiliation: Departmentof Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Xuerong
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Neurology, Taizhou Hospital, Taizhou, China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Jin
authors.affiliation: Department of Neurology, Taizhou Hospital, Taizhou, China.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neurology, Municipal Hospital of Taizhou, Taizhou, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Liang
authors.affiliation: Department of Neurology, Lishui Central Hospital, Lishui, China.
authors.forename: Weiwen
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Departmentof Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Departmentof Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Shao
mesh_terms: D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors
keywords: Acute ischemic stroke; hemorrhagic transformation; intravenous thrombolysis; prior antiplatelet therapy