RT Journal Article
T1 Validation of a clinical-genetics score to predict hemorrhagic transformations after rtPA.
A1 Carrera, Caty
A1 Cullell, Natalia
A1 Torres-Águila, Nuria
A1 Muiño, Elena
A1 Bustamante, Alejandro
A1 Dávalos, Antonio
A1 López-Cancio, Elena
A1 Ribó, Marc
A1 Molina, Carlos A
A1 Giralt-Steinhauer, Eva
A1 Soriano-Tárraga, Carolina
A1 Mola-Caminal, Marina
A1 Jiménez-Conde, Jordi
A1 Roquer, Jaume
A1 Vives-Bauza, Cristófol
A1 Navarro, Rosa Díaz
A1 Obach, Victor
A1 Arenillas, Juan Francisco
A1 Segura, Tomás
A1 Serrano-Heras, Gemma
A1 Martí-Fàbregas, Joan
A1 Freijo, Marimar
A1 Cabezas, Juan Antonio
A1 Tatlisumak, Turgut
A1 Heitsch, Laura
A1 Ibañez, Laura
A1 Cruchaga, Carlos
A1 Lee, Jin-Moo
A1 Strbian, Daniel
A1 Montaner, Joan
A1 Fernández-Cadenas, Israel
A1 Spanish Stroke Genetic Consortium, 
AB To validate the Genot-PA score, a clinical-genetic logistic regression score that stratifies the thrombolytic therapy safety, in a new cohort of patients with stroke. We enrolled 1,482 recombinant tissue plasminogen activator (rtPA)-treated patients with stroke in Spain and Finland from 2003 to 2016. Cohorts were analyzed on the basis of ethnicity and therapy: Spanish patients treated with IV rtPA within 4.5 hours of onset (cohort A and B) or rtPA in combination with mechanical thrombectomy within 6 hours of onset (cohort C) and Finnish participants treated with IV rtPA within 4.5 hours of onset (cohort D). The Genot-PA score was calculated, and hemorrhagic transformation (HT) and parenchymal hematoma (PH) risks were determined for each score stratum. Genot-PA score was tested in 1,324 (cohort A, n = 726; B, n = 334; C, n = 54; and D, n = 210) patients who had enough information to complete the score. Of these, 213 (16.1%) participants developed HT and 85 (6.4%) developed PH. In cohorts A, B, and D, HT occurrence was predicted by the score (p = 2.02 × 10-6, p = 0.023, p = 0.033); PH prediction was associated in cohorts A through C (p = 0.012, p = 0.034, p = 5.32 × 10-4). Increased frequency of PH events from the lowest to the highest risk group was found (cohort A 4%-15.7%, cohort B 1.5%-18.2%, cohort C 0%-100%). The best odds ratio for PH prediction in the highest-risk group was obtained in cohort A (odds ratio 5.16, 95% confidence interval 1.46-18.08, p = 0.009). The Genot-PA score predicts HT in patients with stroke treated with IV rtPA. Moreover, in an exploratory study, the score was associated with PH risk in mechanical thrombectomy-treated patients.
YR 2019
FD 2019-07-31
LK https://hdl.handle.net/10668/27775
UL https://hdl.handle.net/10668/27775
LA en
DS RISalud
RD Apr 17, 2025