Risk factors of hemorrhagic transformation after intravenous thrombolysis with rt-PA in acute cerebral infarction

Background: Intravenous thrombolysis is considered to be the standard reperfusion therapy for acute ischemic stroke, but its application is limited by high risk of hemorrhagic transformation (HT) after thrombolysis. Aim: This study aimed to identify risk factors of HT after intravenous thrombolysis. Methods: Patients with acute ischemic stroke receiving rt-PA thrombolysis from February 2013 to January 2018 were retrospectively reviewed. They were divided into HT group and non-HT group based on cranial computed tomography. Data of all patients were collected and analysed by univariate analysis and stepwise logistic regression analysis. Results: A total of 403 patients were enrolled and their age ranged from 13 to 86 years, with an average age of 67.01 +/- 31.88 years. 136 (33.7%) patients were females. The average time from disease onset to thrombolysis was 52.05 +/- 20.12 min, and 46 patients (11.4%) had HT after thrombolysis. We found significant differences in activated partial thromboplastin time, fibrinogen value, platelet value and smoking before thrombolysis between HT and non-HT group (P<0.05). Conclusion: Smoking, prolongation of activated partial thromboplastin time, low fibrinogen levels and low platelet counts are associated with the risk of HT and could help the selection of thrombolytic patients to avoid HT.