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  • Risk factors of haemorrhagic transformation for acute ischaemic stroke in Chinese patients receiving intravenous recombinant tissue plasminogen activator: a systematic review and meta-analysis

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Original article
Risk factors of haemorrhagic transformation for acute ischaemic stroke in Chinese patients receiving intravenous recombinant tissue plasminogen activator: a systematic review and meta-analysis
  1. Yijia Guo,
  2. Yaqiong Yang,
  3. Muke Zhou,
  4. Li He
  1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
  1. Correspondence to Dr Muke Zhou; zmkemail{at}126.com and Dr. Li He; heli2003new{at}126.com

Abstract

Objective To identify risk factors for haemorrhagic transformation in Chinese patients with acute ischaemic stroke treated with recombinant tissue plasminogen activator.

Methods We searched electronic databases including PubMed, EMBASE, CNKI and WanFang Data for studies reporting risk factors of haemorrhagic transformation after intravenous thrombolysis. Pooled OR, weighted mean difference (WMD) and 95% CI were estimated. Meta-analysis was performed by using Stata V.14.0 software.

Results A total of 14 studies were included. The results indicated that older age (WMD=3.46, 95% CI 2.26 to 4.66, I2=47), atrial fibrillation (OR 2.66, 95% CI 1.85 to 3.81, I2=28), previous stroke (OR 1.68, 95% CI 1.08 to 2.60, I2=14), previous antiplatelet treatment (OR 1.67, 95% CI 1.17 to 2.38, I2=0), higher National Institute of Health stroke scale scores (OR 1.10, 95% CI 1. 05 to 1.15, I2=36), systolic (WMD=4.75, 95% CI 2.50 to 7.00, I2=42) or diastolic (WMD=2.67, 95% CI 1.08 to 4.26, I2=35) pressure, and serum glucose level (WMD=1.44, 95% CI 0.62 to 2.26, I2=66) were associated with increased risk of post-thrombolysis haemorrhagic transformation.

Conclusion The current meta-analysis identified eight risk factors for post-thrombolysis haemorrhagic transformation in Chinese patients with acute ischaemic stroke. Given the risk of bias, these results should be explained with caution and do not justify withholding intravenous thrombolysis.

  • acute ischemic stroke
  • recombinant tissue plasminogen activator
  • hemorrhagic transformation
  • risk factor
  • meta-analysis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/svn-2018-000141

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    Footnotes

    • MZ and LH contributed equally.

    • Contributors YG designed the study, collected and extracted data, and drafted the manuscript. YY collected and extracted data. MZ revised manuscript critically for important intellectual content. LH approved of the version to be published.

    • Funding This work was supported by the National Natural Science Foundation of China (grant no. 81571153).

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.