High glycemic albumin representing prestroke glycemic variability is associated with hemorrhagic transformation in patients receiving intravenous thrombolysis

• Published in: Scientific reports Vol. 12; no. 1; pp. 615 - 8
• Main Authors: Lee, Sang-Hwa, Jang, Min Uk, Kim, Yerim, Park, So Young, Kim, Chulho, Kim, Yeo Jin, Sohn, Jong-Hee
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 12.01.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/499; 692/617/375; Aged; Aged, 80 and over; Albumin; Cerebral Hemorrhage - blood; Cerebral Hemorrhage - etiology; Female; Genetic transformation; Glycation End Products, Advanced - blood; Hemorrhage; Humanities and Social Sciences; Humans; Intravenous administration; Ischemia; Ischemic Stroke - blood; Ischemic Stroke - therapy; Male; Middle Aged; multidisciplinary; Regression analysis; Retrospective Studies; Risk assessment; Science; Science (multidisciplinary); Serum Albumin; Stroke; Thrombolysis; Thrombolytic drugs; Thrombolytic Therapy - adverse effects
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-04716-4

We evaluated the impact of prestroke glycemic variability estimated by glycated albumin (GA) on symptomatic hemorrhagic transformation (SHT) in patients with intravenous thrombolysis (IVT). Using a multicenter database, we consecutively enrolled acute ischemic stroke patients receiving IVT. A total of 378 patients were included in this study. Higher GA was defined as GA ≥ 16.0%. The primary outcome measure was SHT. Multivariate regression analysis and a receiver operating characteristic curve were used to assess risks and predictive ability for SHT. Among the 378 patients who were enrolled in this study, 27 patients (7.1%) had SHT as defined by the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SHT SITS ). The rate of SHT SITS was higher in the higher GA group than in the lower GA group (18.0% vs. 1.6%, p  < 0.001). A higher GA level (GA ≥ 16.0%) significantly increased the risk of SHT SITS (adjusted odds ratio [OR], [95% confidence interval, CI], 12.57 [3.08–41.54]) in the logistic regression analysis. The predictive ability of the GA level for SHT SITS was good (AUC [95% CI]: 0.83 [0.77–0.90], p  < 0.001), and the cutoff value of GA in SHT was 16.3%. GA was a reliable predictor of SHT after IVT in acute ischemic stroke in this study.