Analysis of the risk factors of intracranial hemorrhagic transformation in acute cerebral infarction with non-valvular atrial fibrillation patients within 14-days / 中国神经精神疾病杂志

ABSTRACT

Objective To investigate the risk factors of intracranial hemorrhagic (ICH) transformation within 14-days in acute cerebral infarction with non-valvular atrial fibrillation (NVAF) patients. Methods CT and/or MRI scans of the head were conducted within 14 days on patients with NVAF acute cerebral infarction who admitted to the Department of Neurology, Huizhou Municipal Central Hospital between January 2015 to March 2018. The baseline scan data were reviewed to determine whether ICH conversion occurred. Comparable risk assessment were based on stratification scores using HAS-BLED, ASPECTS, and pc-ASPECTS. Results There were 150 cases of acute cerebral infarction with NVAF, 126 patients were eligible for the analysis, with an ICH conversion rate of 27.0% (34/126). The following four risk factors were statistically significant among the ICH and non-ICH transformation groups ①systolic blood pressure (SBP) >160 mmHg or diastolic blood pressure (DBP) >100 mmHg post-cerebral infarction, ②Severe cerebral infarction, progressing stroke, ③ASPECTS (pc-ASPECTS) score ≤7 points, and ④ HAS-BLED score ≥3 points (P<0.05). Conclusion Approximately 1/3 of NVAF acute cerebral infarction patients experience an ICH transformation within 14 days of their episode. The following indicators are independent risk factors of ICH transformation SBP >160mmHg or DBP >100mmHg after cerebral infarction, severe cerebral infarction, progressing stroke, ASPECTS (pc-ASPECTS)≤7 points, and HAS-BLED score≥3 points.