Ischemic Strokes

Ischemic
Strokes

  

• Jailard
  A, for the Multicenter Stroke Trial – Europe Group
  [Univ. Hosp. Grenoble, France]
  
  Hemorrhagic
  Transformation in Acute Ischemic Stroke : The Mast-E
  Study
  
  Stroke
  30 : 1326-1332, 1999
  
      
  
  The
  risk factors for hemorrhagic transformation [HT],
  following the administration
  of streptokinase after stroke, have not been
  well studied. The occurrence and the late predictors
  of cerebral HT in both strptokinase and placebo group
  was investigated in a post hoc analysis of data from
  the double-blind, controlled, Multicenter Acute Stroke
  Trial Europe [MAST-E] Study.
  
      
  
  Three hundred and ten patients received either
  1,500,000 units of streptokinase [n=156] or placebo
  [n=154], administered intravenously, within 6 hours of
  the onset of stroke symptoms. Mortality and severe
  disability were assessed at 6 months’ followup,
  safety was evaluated at 10 days, and asymptomatic HT
  and symptomatic HT [SHT] were evaluated by CT within 5
  days.
  
       
  
  HT was seen in 96 patients [61%] in the streptokinase
  group [37 with SHT] and
  in 61 patients [31%] in the placebo group [ 4 with SHT].
  Patients with SHT were significantly more
  likely to have diabetes, atrial fibrillation, no
  heparin use, streptokinase treatment, and early CT
  signs.
  
       
  
  According
  to the study, early CT signs, were strong predictors
  of HT and SHT in stroke patients, particularly in the
  streptokinase treated cases.
  Patients with decreased level of consciousness
  were more likely to get SHT.