Acampa M, et al. – This study was conducted to examine a possible link between arterial stiffness and hemorrhagic transformation (HT) occurrence after thrombolytic therapy in patients with ischemic stroke. The clinicians revealed arterial stiffness as a novel independent risk factor for HT after ischemic stroke treated with thrombolysis, proposing a particularly high bleeding risk when arterial stiffness index (ASI) was >0.71.

Methods

• A total of 258 patients (135 males, 123 females; mean age: 73 ± 12 years) with acute ischemic stroke undergoing intravenous thrombolysis or/and mechanical thrombectomy were enrolled.
• For this study, all stroke patients underwent neuroimaging examination, 24-h heart rate and blood pressure monitoring and brain CT-scan after 24–72 h to evaluate HT occurrence.
• They obtained the linear regression slope of diastolic on systolic blood pressure and assumed as a global measure of arterial compliance, and its complement (1 minus the slope), named arterial stiffness index (ASI), has been taken as a measure of arterial stiffness.

Results

• HT occurred in 55 patients among 258 patients.
• In patients with HT, ASI was significantly higher than in patients without HT (0.70 ± 0.12 vs 0.62 ± 0.14, p < 0.001).
• Logistic regression model demonstrated ASI as independent predictors of HT (OR: 1.9, 95% CI: 1.09-3.02, for every 0.2 increase of ASI): in particular, OR was 5.2 (CI: 2.22-12.24) when ASI was >0.71, in comparison with ASI lower than 0.57.