Association Between Coagulation Function and Spontaneous Hemorrhagic Transformation in Acute Ischemic Stroke

Area of Science:

• Neurology
• Hematology
• Biochemistry

Background:

• Hemorrhagic transformation (HT) negatively impacts acute ischemic stroke prognosis.
• The association between coagulation function and HT is not fully understood.
• Investigating coagulation markers is crucial for predicting HT risk.

Purpose of the Study:

• To examine the relationship between specific coagulation function indicators and spontaneous HT in acute ischemic stroke patients.
• To identify coagulation markers that predict the risk of developing HT.
• To clarify inconsistencies in previous research on coagulation and HT.

Main Methods:

• Included 1141 patients with acute ischemic stroke within 7 days of onset, excluding those receiving reperfusion therapy.
• Measured coagulation parameters: prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), thrombin time (TT), and fibrinogen (FIB).
• Utilized binary logistic regression to analyze the association between coagulation indicators and HT, assessing them as continuous and categorized variables.

Main Results:

• 102 patients (8.9%) experienced HT, with 14 (1.2%) having symptomatic HT.
• Elevated thrombin time (TT) was independently and inversely associated with HT risk.
• No significant association was found between PT, INR, APTT, or FIB and HT risk.

Conclusions:

• Coagulation function is not uniformly associated with spontaneous HT in acute ischemic stroke.
• Prolonged thrombin time (TT) is an independent predictor of reduced HT risk.
• This suggests the final step of coagulation may play a protective role against HT.