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A higher body temperature is associated with hemorrhagic transformation in patients with accute stroke non-treated with recombinant tissue-type plasminogen activator (rtPA).
MedLine Citation:
PMID:  21861843     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Higher body temperature is a prognostic factor of poor outcome in acute stroke. Our aim was to study the relationship between body temperature, hemorrhagic transformation (HT), and biomarkers of blood-brain barrier (BBB) damage in patients with acute ischemic stroke non-treated with recombinant tissue-type plasminogen activator (rtPA). We studied 229 patients with ischemic stroke <12 hours from symptom onset. Body temperature was determined at admission and every 6 hours during the first 3 days. HT was evaluated according to ECASS II criteria in a multimodal MRI at 72 hours. We found that 55 patients (34.1%) showed HT. HT was associated with cardioembolic stroke (64.2 vs. 23.0 %; p<0.0001), higher body temperature during the first 24 hours (36.9 vs. 36.5 ºC; p<0.0001), more severe stroke (NIHSS score, 14 [9-20] vs. 10 [7-15]; p=0.002), and greater DWI lesion volume at admission (23.2 vs. 13.2 cc; p<0.0001). Plasma MMP-9 (187.3 vs. 44.2 ng/mL; p<0.0001), and cFn levels (16.3 vs. 7.1 mg/mL; p=0.001) were higher in patients with HT. Body temperature within the first 24 hours was independently associated with HT (OR, 7.3; CI 95%, 2.4 to 22.6; p<0.0001) after adjustment for cardioembolic stroke subtype, baseline NIHSS score and DWI lesion volume. This effect remained unchanged after controlling for MMP-9 and cFn. In conclusion, high body temperature within the first 24 hours after ischemic stroke is a risk factor for HT in patients non-treated with rtPA. This effect is independent of some biological signatures of BBB damage.
Authors:
Rogelio Leira; Tomás Sobrino; Miguel Blanco; Francisco Campos; Manuel Rodríguez-Yáñez; Mar Castellanos; Octavio Moldes; Mónica Millán; Antoni Dávalos; José Castillo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-23
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  -     ISSN:  1470-8736     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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