@article{ddba1e21cb4f4c2d8a82f5eb4fbe1efe,
title = "Is asymptomatic hemorrhagic transformation really innocuous?",
abstract = "Objectives: Asymptomatic hemorrhagic transformation (HT) is not associated with immediate deterioration of patients with acute ischemic stroke. However, it is unclear whether it is clinically innocuous with respect to long-term outcome. The aim of this study was to determine the impact of asymptomatic HT on 3-month outcome. Methods: A consecutive series of 1,618 patients, hospitalized between January 2004 and August 2007 for ischemic stroke within 7 days from symptom onset were identified in a prospective stroke registry database. Those who had no evidence of acute cerebral ischemia on diffusionweighted MRI, who did not undergo T2-weighted gradient echo MRI, whose modified Rankin Scale (mRS) score at 3 months after stroke onset was not available, or who had symptomatic HT were excluded. The odds ratio (OR) of asymptomatic HT was calculated for the full distribution of mRS score and adjusted for variables with p < 0.25 with respect to their associations with asymptomatic HT or functional outcome. Results: Of 1,412 patients eligible for the study, 100 (7.1%) had asymptomatic HT. Patients who experienced asymptomatic HT were more likely to have cardioembolic stroke, to receive thrombolytic therapy, to receive anticoagulation with heparin, and to have a higher initial NIH Stroke Scale score. The crude and adjusted ORs of asymptomatic HT for an increment of mRS score at 3 months were 2.94 (95% confidence interval 2.05-4.24) and 1.90 (1.27-2.82), respectively. Conclusions: Our study shows that the odds of a worse outcome are increased by a factor of 2 in patients with asymptomatic HT compared with those without HT after acute ischemic stroke.",
author = "Park, {J. H.} and Y. Ko and Kim, {W. J.} and Jang, {M. S.} and Yang, {M. H.} and Han, {M. K.} and Oh, {C. W.} and Park, {S. H.} and Jisung Lee and Juneyoung Lee and Bae, {H. J.} and Gorelick, {P. B.}",
note = "Funding Information: Study funding: Supported by the Korea Health 21 Research and Development project, Ministry of Health and Welfare, Republic of Korea. Funding Information: Dr. J.H. Park, Dr. Ko, Dr. Kim, M.S. Jang, M.H. Yang, and Dr. Han report no disclosures. Dr. Oh receives research support from the Korea Health 21 R&D Project, Ministry of Health, Welfare and Family Affairs, Republic of Korea and Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea. Dr. S.H. Park, Dr. Jiseong Lee, and Dr. Juneyoung Lee report no disclosures. Dr. Bae serves on scientific advisory boards for Bayer Schering Pharma, Novartis, MSD, and Boehringer Ingelheim; has received funding for travel from Bristol-Myers Squibb, Pfizer Inc, Daewoong Pharmaceutical Co., Ltd., and Otsuka Pharmaceutical Co., Ltd.; serves as a consultant for Yu Y{\"u} Pharmaceutical Co., Ltd., Daewoong Pharmaceutical Co., Ltd., and Wyeth; serves on speakers' bureaus for MSD, AstraZeneca, sanofi-aventis, Handok Pharmaceuticals Co., Ltd., Chong Kun Dang Pharmaceutical Co., Ltd., Bristol-Myers Squibb, Otsuka Pharmaceutical Co., Ltd., and Pfizer Inc; and receives research support from Eisai Inc., Handok Pharmaceuticals Co., Ltd., AstraZeneca, sanofi-aventis, Servier, Novartis Korea, Bayer Schering Pharma, Otsuka Pharmaceutical Co., Ltd., Pfizer Inc, Daiichi Sankyo, Yuhan Corporation, Dong-A Pharmaceutical Co., Ltd., and Ministry of Health, Welfare and Family Affairs, Republic of Korea. Dr. Gorelick serves on scientific advisory boards or steering committees for BrainsGate, D-Pharm Limited, Boehringer Ingelheim, and Lundbeck; serves on the editorial board of Stroke; serves as a consultant for Genentech, Inc. and Boehringer Ingelheim; serves on the speakers' bureau of Boehringer Ingelheim; serves as the Director of the US DIAS 4 in acute ischemic stroke Clinical Coordinating Center for Lundbeck, Inc.; and has served as an expert witness in medico-legal cases.",
year = "2012",
month = feb,
day = "7",
doi = "10.1212/WNL.0b013e318245d22c",
language = "English",
volume = "78",
pages = "421--426",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "6",
}