Factors influencing hemorrhagic transformation in ischemic stroke patients with atrial fibrillation: a hospital based-study

Background Patients with ischemic stroke and atrial fibrillation (AF) are at high risk of developing hemorrhagic transformation (HT). The aim of the current study is to evaluate the incidence of hemorrhagic transformation and associated risk factors in a hospital-based sample with ischemic stroke and AF patients. A prospective study with a total of 234 stroke patients with AF was consecutively recruited. HT incidence was determined by computed tomography (CT) or magnetic resonance imaging (MRI). Risk factors associated with HT was identified by comparing patients with and without HT. Results The incidence of HT in ischemic stroke with AF was 22.6%. Univariate analysis established that old age, hypertension, diabetes mellitus, anticoagulant medications, NIHSS, cerebral microbleeds (CMB), superficial siderosis (SS) and size of infarction were significantly more frequent with HT. Multivariable logistic regression analysis demonstrated that old age [odds ratio (OR): 1.05, confidence interval (CI) 1.01–1.09], size of infarction (OR: 2.57, CI 1.06–6.27) and CMB ≥ 10 (OR: 4.68, CI 1.71–12.84) were significantly associated with the risk of HT. Conclusions Older age, larger infarction size, and CMB ≥ 10 were risk factors significantly associated with HT.