Septic cerebral emboli as a risk factor for thrombolysis-related haemorrhagic transformation

For the sake of completeness the risk factors enumerated by Wanget al. for haemorrhagic transformation of acute cerebral infarcts after intravenous thrombolysis (IVT)1 ought to include infective endocarditis (IE)-related septic emboli.2 In the latter study, which covered the period 2002 –10, 222 patients (mean age 69; 46% female) were identified who were treated with IVT for acute ischaemic stroke associated with IE. These patients were compared with 134 048 counterparts (mean age 69; 49% female) treated with IVT in the absence of IE. The rate of IVT-related intracerebral haemorr hage was significantly (P = 0.006) higher (20% vs. 6.5%) in patients with IE than in those without IE. Furthermore there was a significantly (P = 0.01) lower rate of favourable outcome in the IE subgroup.2
Source: QJM - Category: Internal Medicine Source Type: research