Abstract WP70: Cause of Stroke is not Associated With the Risk of Symptomatic Post-thrombolytic Intracerebral Hemorrhage

Abstract

Background and Purpose: The risk of intracranial hemorrhage following intravenous thrombolysis (IVT) is increased by various factors including the underlying vessel conditions and the mechanisms of vessel occlusion, the location of the occlusion, and the extent of ischemic changes with subsequent blood-brain-barrier disruption. We hypothesized that the stroke etiology is associated with the risk of symptomatic intracerebral hemorrhage (sICH). Methods: A consecutive cohort of 2485 IVT-treated patients at the Helsinki University Central Hospital was classified according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. A sICH was classified according to the European Cooperative Acute Stroke Study II criteria. The associations of sICH with nominal, ordinal, and continuous variables were analyzed in a univariate binary regression model and adjusted in multivariate binary regression models. Results: In univariate analyses cardioembolism (OR 1.14; 95% CI 0.79-1.64) and large-artery atherosclerosis (OR 1.30; 95% CI 0.85-2.00) were not associated with sICH, and small-vessel occlusion was associated with a lower risk of sICH (OR 0.18; 95% CI 0.06-0.57). When adjusted for previously identified factors associated with sICH (see Table), none of the TOAST categories was associated with a higher or lower risk of sICH compared with the the rest of the causes. Conclusions: The risk of sICH in IVT-treated patients is not significantly associated with the cause of stroke.