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Limited administration of thrombolytic drugs in stroke patients is largely due to the fear of HT. However, hemorrhagic transformation (HT) is common in patients with IVT, occurring as a consequence of coagulation dysfunction and blood-brain barrier (BBB) disruption induced by rt-PA ( 2, 3).
#MAGNESIUM IV ANTI STROKE ACTIVATOR#
Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) is the preferred treatment for acute ischemic stroke patients in super earlier period (≤ 4.5 h) ( 1). No association between symptomatic HT and serum magnesium levels was observed in our study (OR per 0.1-mmol/L increase 0.52, 95% CI 0.25–1.11, p = 0.092).Ĭonclusions: Lower serum magnesium levels in patients with ischemic stroke are associated with an increased risk of HT after intravenous thrombolysis, but perhaps only when serum magnesium is below a certain minimal concentration.
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This threshold effect was also observed in the restricted cubic spline model when serum magnesium levels were above 0.88 mmol/L. However, this association did not persist when baseline levels of serum magnesium were higher than the median value (0.85 mmol/L) in subgroup analysis (OR per 0.1-mmol/L increase 0.58, 95% CI 0.14–2.51, p = 0.47). Multivariable logistic regression analysis indicated that patients with higher serum magnesium levels had lower risk of HT (OR per 0.1-mmol/L increase 0.43, 95% CI 0.27–0.73, p = 0.002). Patients with HT had significant lower serum magnesium levels than those without HT (0.81 ± 0.08 vs.
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Results: Of the 242 included patients, 43 (17.8%) developed HT. The relationship between serum magnesium levels and HT was examined using multivariate logistic regression, subgroup analysis, and restricted cubic spline models. Baseline serum magnesium levels were measured before intravenous thrombolysis, and the occurrence of HT was evaluated using computed tomography images reviewed within 24–36 h after therapy. Methods: We retrospectively analyzed data from 242 patients who received thrombolytic therapy at the Second Affiliated Hospital of the Wenzhou Medical University in China. This study aimed to investigate the relationship between serum magnesium levels and hemorrhagic transformation (HT) after thrombolytic therapy.