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Published on: July 3, 2014
Hemorrhagic transformation in acute ischemic stroke. The MAST-E study. MAST-E Group
A Jaillard1, C Cornu, A Durieux
1Department of Clinical and Biological Neurosciences, Stroke Unit, INSERM U 438, University Hospital, Grenoble, France. Assia.Jaillard@ujf-grenoble.fr
Stroke
|July 2, 1999
Summary
Hemorrhagic transformation (HT) after acute stroke treatment is common. Early CT signs and streptokinase treatment predict HT and symptomatic hemorrhages (SHT), guiding risk assessment.
Area of Science:
- Neurology
- Stroke Research
- Thrombolytic Therapy
Background:
- Hemorrhagic transformation (HT) is a critical complication of thrombolytic therapy in acute stroke.
- Understanding HT predictors is vital for patient safety in stroke trials.
Purpose of the Study:
- To determine the rates and predictors of HT and symptomatic hemorrhages (SHT) in the Multicenter Acute Stroke Trial-Europe (MAST-E).
Main Methods:
- Post hoc analysis of MAST-E data involving intravenous streptokinase within 6 hours of stroke onset.
- HT defined as intracerebral or symptomatic hemorrhages; SHT associated with clinical worsening.
- Multivariate modeling used to identify predictors of HT and SHT.
Main Results:
- 159 of 310 patients experienced HT; 37 had SHT.
- Predictors of HT included early CT signs and streptokinase treatment.
- SHT predictors were diabetes mellitus, early CT signs, streptokinase treatment, and interaction with decreased consciousness.
Conclusions:
- Streptokinase's relative risk of HT in MAST-E aligns with other trials.
- Early CT signs are strong predictors for both HT and SHT.
- Predictors of HT and SHT in this study mirror those found in tPA trials for acute stroke.
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