Abstract T MP58: Asymptomatic Hemorrhagic Transformation after Acute Ischemic Stroke: Is It Clinically Innocuous?
Background and Purpose: Whether asymptomatic hemorrhagic transformation (HT) is clinically innocuous, i.e. unassociated with clinically detectable neurological deterioration, remains an open question. To explore this, we examined whether asymptomatic HT affects long-term mortality, disability and risk of stroke recurrence.
Methods: We consecutively and prospectively enrolled patients with acute ischemic stroke who were admitted to our hospital. Based on clinical and imaging data, patients were diagnosed as having asymptomatic HT or not, and the two groups were compared in terms of basic clinical characteristics, functional outcomes, mortality, and stroke recurrence.
Results: Of the 1764 patients enrolled, 143 (8.1%) presented with asymptomatic HT. These patients were more likely to be male, to have experienced atrial fibrillation and cardioembolic stroke, and to have higher NIHSS score on admission than were patients without asymptomatic HT. After adjusting for age, gender, and NIHSS score on admission, the proportion of patients with disability was significantly higher among those with asymptomatic HT than among those without, both at 3 months and 1 year. However, risk of mortality was not significant after adjusting the data. Nevertheless, patients with asymptomatic HT showed a significantly lower cumulative one-year survival rate than did those without asymptomatic HT (P=0.02). Both groups of patients showed similar rates of cumulative stroke recurrence at 1 year (P = 0.54).
Conclusions: Asymptomatic HT after acute ischemic stroke worsened long-term clinical outcomes, although it did not affect risk of stroke recurrence. These findings suggest that asymptomatic HT should not be considered clinically innocuous.
Author Disclosures: B. Wu: None.
- © 2014 by American Heart Association, Inc.