Abstract T P65: Prior Stroke but Not Diabetes Mellitus Is Associated with Symptomatic Intracranial Hemorrhage after Rt-PA Administration
Introduction: The European drug license for rt-PA considers diabetes plus previous stroke as an exclusion criterion for the administration of the treatment due to an increased risk of symptomatic intracranial hemorrhage (SICH). However, given that data from different studies have not confirmed this association, we were interested in analyzing whether the presence of these pathologies was associated with the development of SICH in our population of rt-PA-treated patients.
Patients and methods: For the purpose of this study, we evaluated 667 patients treated with rt-PA at our center between October 1999 and December 2012. The existence of bleeding was assessed in the cranial CT performed at 24±12 h after rt-PA administration and was considered to be symptomatic when it was associated with neurological deterioration, which was defined as an increase ≥4 points in the NIHSS. Previous history of diabetes and stroke was collected from all patients.
Results: 176 (26.4%) had hemorrhagic transformation (HT), which was symptomatic in 30 cases (4.5%). In the univariate analysis, neither diabetes and previous stroke together, nor alone, were associated with HT. However, previous stroke (10% vs. 4%, p=0.028) but not diabetes or both, was associated with SICH. After adjustment for the rest of the variables associated with the development of SICH, only the history of prior stroke remained as an independent predictor of this complication (OR 4.3;CI 95%, 1.12-16.19; p=0.03).
Conclusions: In our large cohort of patients treated with rt-PA, only a prior history of stroke predicted the development of SICH. No association was found with diabetes.
Author Disclosures: C. van Eendenburg: None. J. Serena: None. Y. Silva: None. M. Terceño: None. J. Puig: None. G. Blasco: None. S. Pedraza: None. M. Kazimierczak: None. M. Castellanos: None.
- © 2014 by American Heart Association, Inc.