Abstract TP67: Micro- and Macroalbuminuria After Intravenous Thrombolysis May Predict Hemorrhagic Transformation in Acute Ischemic Stroke

Abstract

Introduction: Endothelial disruption might be one of the mechanisms related to the development of hemorrhagic transformation (HT) in cerebral ischemia. Dysfunction of the vascular endothelium may be explained by a link between micro/macroalbuminuria and increased risk of cardiovascular disease. Hypothesis: We hypothesized that micro- and macroalbuminuria could be a predictor of HT after intravenous thrombolysis (IVT) in acute ischemic stroke. Therefore, this study assessed the hypothesis that micro- and macroalbuminuria might be associated with HT after IVT in patients with acute ischemic stroke and sought to investigate whether the value of urinary albumin-to-creatinine ratios (UACR) would correlate with the degree of HT. Methods: This was a retrospective study of stroke patients who had undergone IVT within 3 hours of symptom onset. Albuminuria assessment was based on random morning spot urine collection with patients in a fasting state, the first morning after IVT. HT was assessed by means of follow-up DWI obtained 24 and 72 hours after IVT. HT was classified as HI and parenchymal hematoma according to the ECASS criteria. We defined symptomatic intracranial hemorrhage (SICH) according to the definitions in the NINDS-tPA trials. Results: 154 patients were included in the study. Fifty-one patients had HT and 12 ones had SICH. The presence of micro- or macroalbuminuria was associated with HT after adjustment for variables with clinical significance (OR, 2.521; 95% CI, 1.105-5.751; p = 0.028). In addition, the presence of micro- or macroalbuminuria was independently associated with SICH after adjustment for variables. There were significant relationships between the presence of micro- and macroalbuminuria and types of HT. Conclusion: In conclusion, the results of this study suggest that the presence of micro- and macroalbuminuria after IVT could be a predictor of HT in patients with acute ischemic stroke and that treatment of albuminuria might prevent HT after IVT in patients with acute ischemic stroke.