Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation: post hoc analysis of the Triple AXEL Trial

Sang Hun Lee; Keun Sik Hong; Ji Sung Lee; Yong Jae Kim; Tae Jin Song; Young Dae Kim; Man Seok Park; Eung Gyu Kim; Jae Kwan Cha; Sang Min Sung; Byung Woo Yoon; Oh Young Bang; Woo Keun Seo; Yang Ha Hwang; Seong Hwan Ahn; Dong Wha Kang; Hyun Goo Kang; Kyung Ho Yu; Sun U. Kwon

doi:10.1016/j.clineuro.2018.08.026

Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation: post hoc analysis of the Triple AXEL Trial

Sang Hun Lee, Keun Sik Hong, Ji Sung Lee, Yong Jae Kim, Tae Jin Song, Young Dae Kim, Man Seok Park, Eung Gyu Kim, Jae Kwan Cha, Sang Min Sung, Byung Woo Yoon, Oh Young Bang, Woo Keun Seo, Yang Ha Hwang, Seong Hwan Ahn, Dong Wha Kang, Hyun Goo Kang, Kyung Ho Yu, Sun U. Kwon

Department of Neurology

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Objectives: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. Patients and methods: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors. We analyzed various factors using data from the Triple AXEL study, such as sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, initial infarction volume, initial infarction location, and new intracranial hemorrhage on follow-up gradient recalled echo or susceptibility-weighted imaging. Results: We analyzed various factors by dividing patients into a new HT group and a no HT group. No correlation was found between HT and risk factors that were significantly associated with HT, including age, sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, and initial infarction volume. When the initial infarction was classified into anterior circulation infarction (ACI) and posterior circulation infarction (PCI), the occurrence of new HT was significantly more associated with PCI than with ACI (57.6% vs 24.0%, P = 0.001). Multivariate logistic regression analysis was performed using HT as a response variable. Only the location of initial infarction according to the vascular territory contributed to the increased risk of HT (OR2.3, 95%CI1.33–3.91, P = 0.003). Conclusion: PCI is a very important independent risk factor for HT in patients with mild AF-related stroke treated with early anticoagulation.

Original language	English
Pages (from-to)	156-162
Number of pages	7
Journal	Clinical Neurology and Neurosurgery
Volume	174
DOIs	https://doi.org/10.1016/j.clineuro.2018.08.026
State	Published - Nov 2018

Bibliographical note

Funding Information:
This study was supported by Bayer Korea Ltd . and grants of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea ( HI14C1061 ) and the Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea ( HI10C2020 ).

Funding Information:
Dr. KS Hong reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Boehringer Ingelheim, grants from Bayer, grants from Ostuka Korea, grants and personal fees from Pfizer Korea, personal fees from Sanofi-Aventis Korea, grants and personal fees from Bayer Korea, grants and personal fees from Boehringer Ingelheim Korea, personal fees from Chong Kun Dang Pharm, personal fees from Dong Wha Pharm, personal fees from United Pharm, personal fees from Daichi Sankyo Korea, outside the submitted work. Dr. SU Kwon reports grants from Bayer Korea Ltd., grants from Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C1061), grants from Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea (HI10C2020), during the conduct of the study; grants and personal fees from Otsuka Korea, grants from Pfizer, grants from Boehringer Ingelheim, personal fees from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Novatis Korea, personal fees from Pfizer Korea, personal fees from Daichi Sankyo Korea, outside the submitted work. PhD. JS Lee reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. YJ Kim reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. TJ Song reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. YD Kim reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. MS Park reports grants from Bayer Korea Ltd., during the conduct of the study. EGK reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. JK Cha reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Otsuka Korea, grants from Bayer Korea, grants from ESAI-Korea, grants from Daewoong Pharmaceutical Co. Ltd, grants from Daichi Sankyo, grants from Pfizer, grants from Sanofi-Aventis Korea, grants from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Boehringer Ingelheim Korea, personal fees from Pfizer Korea, personal fees from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Novatis Korea, personal fees from Ostuka Korea, personal fees from Pfizer Korea, personal fees from Daichi Sankyo Korea, outside the submitted work. Dr. SM Sung reports grants from Bayer Korea Ltd., during the conduct of the study; personal fees from Daiichi Sankyo Korea, personal fees from Pfizer Pharmaceuticals Korea Ltd., outside the submitted work. Dr. BW Yoon reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Bayer HealthCare, grants from Bayer HealthCare, outside the submitted work. Dr. OY Bang reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. WK Seo reports grants from Bayer Korea Ltd., during the conduct of the study; grants and personal fees from Bayer Korea, grants from Korea Otsuka, grants and personal fees from Pfizer Pharmaceuticals, grants and personal fees from Sanofi-Aventis, grants from Daewoong Pharmaceutical Co. Ltd, grants from Myung In pharmaceutical. Co. Ltd, grants from Korea United PHARM. INC., grants and personal fees from Boehringer Ingelheim Korea, personal fees from Daiichi Sankyo Korea, outside the submitted work. Dr. YH Hwang reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Kyungpook National University, outside the submitted work. Dr. SH Ahn reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. DW Kang reports grants from National Research Foundation of Korea (NRF) funded by the Korea government (MEST) (NRF-2014R1A2A1A11051280), grants from Korea Health Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (HI12C1847), grants from Korea Health Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (HI14C1983), outside the submitted work. Dr. KH Yu reports grants from Bayer Korea Ltd., during the conduct of the study; personal fees from Bristol-Myers Squibb, personal fees from Bayer, outside the submitted work. Dr. SH Lee and HG Kang have nothing to disclose.

Funding Information:
This study was supported by Bayer Korea Ltd. and grants of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C1061) and the Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea (HI10C2020).

Publisher Copyright:
© 2018 Elsevier B.V.

Keywords

Anticoagulation
Atrial fibrillation
Hemorrhagic transformation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.clineuro.2018.08.026

Cite this

Lee, S. H., Hong, K. S., Lee, J. S., Kim, Y. J., Song, T. J., Kim, Y. D., Park, M. S., Kim, E. G., Cha, J. K., Sung, S. M., Yoon, B. W., Bang, O. Y., Seo, W. K., Hwang, Y. H., Ahn, S. H., Kang, D. W., Kang, H. G., Yu, K. H., & Kwon, S. U. (2018). Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation: post hoc analysis of the Triple AXEL Trial. Clinical Neurology and Neurosurgery, 174, 156-162. https://doi.org/10.1016/j.clineuro.2018.08.026

@article{4ea39e8a56de48949b6d8ae23c1d91dc,

title = "Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation: post hoc analysis of the Triple AXEL Trial",

abstract = "Objectives: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. Patients and methods: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors. We analyzed various factors using data from the Triple AXEL study, such as sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, initial infarction volume, initial infarction location, and new intracranial hemorrhage on follow-up gradient recalled echo or susceptibility-weighted imaging. Results: We analyzed various factors by dividing patients into a new HT group and a no HT group. No correlation was found between HT and risk factors that were significantly associated with HT, including age, sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, and initial infarction volume. When the initial infarction was classified into anterior circulation infarction (ACI) and posterior circulation infarction (PCI), the occurrence of new HT was significantly more associated with PCI than with ACI (57.6% vs 24.0%, P = 0.001). Multivariate logistic regression analysis was performed using HT as a response variable. Only the location of initial infarction according to the vascular territory contributed to the increased risk of HT (OR2.3, 95%CI1.33–3.91, P = 0.003). Conclusion: PCI is a very important independent risk factor for HT in patients with mild AF-related stroke treated with early anticoagulation.",

keywords = "Anticoagulation, Atrial fibrillation, Hemorrhagic transformation",

author = "Lee, {Sang Hun} and Hong, {Keun Sik} and Lee, {Ji Sung} and Kim, {Yong Jae} and Song, {Tae Jin} and Kim, {Young Dae} and Park, {Man Seok} and Kim, {Eung Gyu} and Cha, {Jae Kwan} and Sung, {Sang Min} and Yoon, {Byung Woo} and Bang, {Oh Young} and Seo, {Woo Keun} and Hwang, {Yang Ha} and Ahn, {Seong Hwan} and Kang, {Dong Wha} and Kang, {Hyun Goo} and Yu, {Kyung Ho} and Kwon, {Sun U.}",

note = "Funding Information: This study was supported by Bayer Korea Ltd . and grants of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea ( HI14C1061 ) and the Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea ( HI10C2020 ). Funding Information: Dr. KS Hong reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Boehringer Ingelheim, grants from Bayer, grants from Ostuka Korea, grants and personal fees from Pfizer Korea, personal fees from Sanofi-Aventis Korea, grants and personal fees from Bayer Korea, grants and personal fees from Boehringer Ingelheim Korea, personal fees from Chong Kun Dang Pharm, personal fees from Dong Wha Pharm, personal fees from United Pharm, personal fees from Daichi Sankyo Korea, outside the submitted work. Dr. SU Kwon reports grants from Bayer Korea Ltd., grants from Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C1061), grants from Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea (HI10C2020), during the conduct of the study; grants and personal fees from Otsuka Korea, grants from Pfizer, grants from Boehringer Ingelheim, personal fees from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Novatis Korea, personal fees from Pfizer Korea, personal fees from Daichi Sankyo Korea, outside the submitted work. PhD. JS Lee reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. YJ Kim reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. TJ Song reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. YD Kim reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. MS Park reports grants from Bayer Korea Ltd., during the conduct of the study. EGK reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. JK Cha reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Otsuka Korea, grants from Bayer Korea, grants from ESAI-Korea, grants from Daewoong Pharmaceutical Co. Ltd, grants from Daichi Sankyo, grants from Pfizer, grants from Sanofi-Aventis Korea, grants from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Boehringer Ingelheim Korea, personal fees from Pfizer Korea, personal fees from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Novatis Korea, personal fees from Ostuka Korea, personal fees from Pfizer Korea, personal fees from Daichi Sankyo Korea, outside the submitted work. Dr. SM Sung reports grants from Bayer Korea Ltd., during the conduct of the study; personal fees from Daiichi Sankyo Korea, personal fees from Pfizer Pharmaceuticals Korea Ltd., outside the submitted work. Dr. BW Yoon reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Bayer HealthCare, grants from Bayer HealthCare, outside the submitted work. Dr. OY Bang reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. WK Seo reports grants from Bayer Korea Ltd., during the conduct of the study; grants and personal fees from Bayer Korea, grants from Korea Otsuka, grants and personal fees from Pfizer Pharmaceuticals, grants and personal fees from Sanofi-Aventis, grants from Daewoong Pharmaceutical Co. Ltd, grants from Myung In pharmaceutical. Co. Ltd, grants from Korea United PHARM. INC., grants and personal fees from Boehringer Ingelheim Korea, personal fees from Daiichi Sankyo Korea, outside the submitted work. Dr. YH Hwang reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Kyungpook National University, outside the submitted work. Dr. SH Ahn reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. DW Kang reports grants from National Research Foundation of Korea (NRF) funded by the Korea government (MEST) (NRF-2014R1A2A1A11051280), grants from Korea Health Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (HI12C1847), grants from Korea Health Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (HI14C1983), outside the submitted work. Dr. KH Yu reports grants from Bayer Korea Ltd., during the conduct of the study; personal fees from Bristol-Myers Squibb, personal fees from Bayer, outside the submitted work. Dr. SH Lee and HG Kang have nothing to disclose. Funding Information: This study was supported by Bayer Korea Ltd. and grants of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C1061) and the Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea (HI10C2020). Publisher Copyright: {\textcopyright} 2018 Elsevier B.V.",

year = "2018",

month = nov,

doi = "10.1016/j.clineuro.2018.08.026",

language = "English",

volume = "174",

pages = "156--162",

journal = "Clinical Neurology and Neurosurgery",

issn = "0303-8467",

publisher = "Elsevier",

}

Lee, SH, Hong, KS, Lee, JS, Kim, YJ, Song, TJ, Kim, YD, Park, MS, Kim, EG, Cha, JK, Sung, SM, Yoon, BW, Bang, OY, Seo, WK, Hwang, YH, Ahn, SH, Kang, DW, Kang, HG, Yu, KH & Kwon, SU 2018, 'Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation: post hoc analysis of the Triple AXEL Trial', Clinical Neurology and Neurosurgery, vol. 174, pp. 156-162. https://doi.org/10.1016/j.clineuro.2018.08.026

Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation: post hoc analysis of the Triple AXEL Trial. / Lee, Sang Hun; Hong, Keun Sik; Lee, Ji Sung et al.
In: Clinical Neurology and Neurosurgery, Vol. 174, 11.2018, p. 156-162.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation

T2 - post hoc analysis of the Triple AXEL Trial

AU - Lee, Sang Hun

AU - Hong, Keun Sik

AU - Lee, Ji Sung

AU - Kim, Yong Jae

AU - Song, Tae Jin

AU - Kim, Young Dae

AU - Park, Man Seok

AU - Kim, Eung Gyu

AU - Cha, Jae Kwan

AU - Sung, Sang Min

AU - Yoon, Byung Woo

AU - Bang, Oh Young

AU - Seo, Woo Keun

AU - Hwang, Yang Ha

AU - Ahn, Seong Hwan

AU - Kang, Dong Wha

AU - Kang, Hyun Goo

AU - Yu, Kyung Ho

AU - Kwon, Sun U.

N1 - Funding Information: This study was supported by Bayer Korea Ltd . and grants of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea ( HI14C1061 ) and the Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea ( HI10C2020 ). Funding Information: Dr. KS Hong reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Boehringer Ingelheim, grants from Bayer, grants from Ostuka Korea, grants and personal fees from Pfizer Korea, personal fees from Sanofi-Aventis Korea, grants and personal fees from Bayer Korea, grants and personal fees from Boehringer Ingelheim Korea, personal fees from Chong Kun Dang Pharm, personal fees from Dong Wha Pharm, personal fees from United Pharm, personal fees from Daichi Sankyo Korea, outside the submitted work. Dr. SU Kwon reports grants from Bayer Korea Ltd., grants from Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C1061), grants from Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea (HI10C2020), during the conduct of the study; grants and personal fees from Otsuka Korea, grants from Pfizer, grants from Boehringer Ingelheim, personal fees from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Novatis Korea, personal fees from Pfizer Korea, personal fees from Daichi Sankyo Korea, outside the submitted work. PhD. JS Lee reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. YJ Kim reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. TJ Song reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. YD Kim reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. MS Park reports grants from Bayer Korea Ltd., during the conduct of the study. EGK reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. JK Cha reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Otsuka Korea, grants from Bayer Korea, grants from ESAI-Korea, grants from Daewoong Pharmaceutical Co. Ltd, grants from Daichi Sankyo, grants from Pfizer, grants from Sanofi-Aventis Korea, grants from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Boehringer Ingelheim Korea, personal fees from Pfizer Korea, personal fees from AstraZeneca Korea, personal fees from Bayer Korea, personal fees from Novatis Korea, personal fees from Ostuka Korea, personal fees from Pfizer Korea, personal fees from Daichi Sankyo Korea, outside the submitted work. Dr. SM Sung reports grants from Bayer Korea Ltd., during the conduct of the study; personal fees from Daiichi Sankyo Korea, personal fees from Pfizer Pharmaceuticals Korea Ltd., outside the submitted work. Dr. BW Yoon reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Bayer HealthCare, grants from Bayer HealthCare, outside the submitted work. Dr. OY Bang reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. WK Seo reports grants from Bayer Korea Ltd., during the conduct of the study; grants and personal fees from Bayer Korea, grants from Korea Otsuka, grants and personal fees from Pfizer Pharmaceuticals, grants and personal fees from Sanofi-Aventis, grants from Daewoong Pharmaceutical Co. Ltd, grants from Myung In pharmaceutical. Co. Ltd, grants from Korea United PHARM. INC., grants and personal fees from Boehringer Ingelheim Korea, personal fees from Daiichi Sankyo Korea, outside the submitted work. Dr. YH Hwang reports grants from Bayer Korea Ltd., during the conduct of the study; grants from Kyungpook National University, outside the submitted work. Dr. SH Ahn reports grants from Bayer Korea Ltd., during the conduct of the study. Dr. DW Kang reports grants from National Research Foundation of Korea (NRF) funded by the Korea government (MEST) (NRF-2014R1A2A1A11051280), grants from Korea Health Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (HI12C1847), grants from Korea Health Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (HI14C1983), outside the submitted work. Dr. KH Yu reports grants from Bayer Korea Ltd., during the conduct of the study; personal fees from Bristol-Myers Squibb, personal fees from Bayer, outside the submitted work. Dr. SH Lee and HG Kang have nothing to disclose. Funding Information: This study was supported by Bayer Korea Ltd. and grants of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C1061) and the Korea Healthcare technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea (HI10C2020). Publisher Copyright: © 2018 Elsevier B.V.

PY - 2018/11

Y1 - 2018/11

N2 - Objectives: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. Patients and methods: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors. We analyzed various factors using data from the Triple AXEL study, such as sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, initial infarction volume, initial infarction location, and new intracranial hemorrhage on follow-up gradient recalled echo or susceptibility-weighted imaging. Results: We analyzed various factors by dividing patients into a new HT group and a no HT group. No correlation was found between HT and risk factors that were significantly associated with HT, including age, sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, and initial infarction volume. When the initial infarction was classified into anterior circulation infarction (ACI) and posterior circulation infarction (PCI), the occurrence of new HT was significantly more associated with PCI than with ACI (57.6% vs 24.0%, P = 0.001). Multivariate logistic regression analysis was performed using HT as a response variable. Only the location of initial infarction according to the vascular territory contributed to the increased risk of HT (OR2.3, 95%CI1.33–3.91, P = 0.003). Conclusion: PCI is a very important independent risk factor for HT in patients with mild AF-related stroke treated with early anticoagulation.

AB - Objectives: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. Patients and methods: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors. We analyzed various factors using data from the Triple AXEL study, such as sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, initial infarction volume, initial infarction location, and new intracranial hemorrhage on follow-up gradient recalled echo or susceptibility-weighted imaging. Results: We analyzed various factors by dividing patients into a new HT group and a no HT group. No correlation was found between HT and risk factors that were significantly associated with HT, including age, sex, history of hypertension, diabetes, microbleeds, concomitant antiplatelet use, and initial infarction volume. When the initial infarction was classified into anterior circulation infarction (ACI) and posterior circulation infarction (PCI), the occurrence of new HT was significantly more associated with PCI than with ACI (57.6% vs 24.0%, P = 0.001). Multivariate logistic regression analysis was performed using HT as a response variable. Only the location of initial infarction according to the vascular territory contributed to the increased risk of HT (OR2.3, 95%CI1.33–3.91, P = 0.003). Conclusion: PCI is a very important independent risk factor for HT in patients with mild AF-related stroke treated with early anticoagulation.

KW - Anticoagulation

KW - Atrial fibrillation

KW - Hemorrhagic transformation

UR - http://www.scopus.com/inward/record.url?scp=85053471352&partnerID=8YFLogxK

U2 - 10.1016/j.clineuro.2018.08.026

DO - 10.1016/j.clineuro.2018.08.026

M3 - Article

C2 - 30243187

AN - SCOPUS:85053471352

SN - 0303-8467

VL - 174

SP - 156

EP - 162

JO - Clinical Neurology and Neurosurgery

JF - Clinical Neurology and Neurosurgery

ER -

Prediction of hemorrhagic transformation in patients with mild atrial fibrillation-associated stroke treated with early anticoagulation: post hoc analysis of the Triple AXEL Trial

Abstract

Bibliographical note

Keywords

UN SDGs

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