Clinical and laboratory biomarkers to predict haemorrhagic transformation of ischemic stroke: first data of a prospective study

Abstract

Background: Haemorrhagic transformation of ischemic stroke represents the bleeding in the infarcted areas of the brain after the cerebrovascular accident. The aim of the study was to analyse the clinical parameters and the blood-brain barrier integrity biomarkers as prognostic factors for haemorrhagic transformation of ischemic stroke. Material and methods: 80 patients with acute ischemic stroke, admitted within 24h from onset to the Institute of Neurology and Neurosurgery (Chisinau) in the period from 2018 to 2019 were prospectively analysed. The admission stroke severity, clinical risk factors, laboratory parameters were registered and venous blood for matrix metalloproteinases 2 and 9 measurement was collected. All patients were investigated by brain computer tomography at admission and on day 3, and/or at clinical deterioration for haemorrhagic transformation detection. Discharge status and 3-months follow-up was done to assess the functionality of the patients by the modified Rankin scale value. Results: Haemorrhagic transformation occurred in 11 out of 80 analysed patients, with a higher proportion of women (72.7% vs 52.1%), older age (72.27±3.08y vs 70.66±1.25), and higher admission NIHSS score (15.54 vs 11.23). Both metalloproteinases were slightly increased in the patients with haemorrhagic transformation. Discharge functionality status was lower in the study vs control group (5 vs 3.68) with similar evolution at 3-months follow-up (4.8 vs 3.12). Conclusions: Preliminary data analysis shows correlation between clinical and laboratory biomarkers and the risk of haemorrhagic transformation of ischemic stroke. More patients are required to be enrolled and studied for the statistically significant results.