Glycated albumin predicts haemorrhagic transformation in IVT patients

Glycated albumin (GA) levels, as an estimator of prestroke glycaemic variability, is a good predictor of symptomatic haemorrhagic transformation (SHT) in patients with intravenous thrombolysis (IVT), a recent study has found.

Researchers enrolled 378 patients with available GA data. GA values ≥16.0% were deemed to be high. The primary outcome of interest was SHT as defined according to the Safe Implementation of Thrombolysis in Stroke-Monitoring Study.

Of the participants, 250 had GA <16.0% (mean age 64.9 years, 65.2 percent men) while the remaining 128 were classified as having high GA (mean age 71.5 years, 53.1 percent men). The latter group was older, more likely to have hypertension and diabetes mellitus, and had higher glucose concentrations.

Similarly, the rate of SHT occurrence was significantly higher in the high GA group (18.0 percent vs 1.6 percent; p<0.001), as was the rate of any haemorrhagic transformation (24.2 percent vs 6.8 percent; p<0.001). Moreover, patients with high GA had worse functional outcomes than low GA counterparts, as defined by modified Rankin scale scores of 3–6 at 3 months (55.5 percent vs 36.8 percent; p=0.001).

Logistic regression analysis confirmed that GA ≥16.0% was a significant risk factor for SHT (adjusted odds ratio, 12.57, 95 percent confidence interval, 3.08–41.54).

Receiver operating characteristic curve analysis was then performed to assess the predictive ability of GA on SHT. The resulting area under the curve was 0.83 (p<0.001), suggesting close to good predictive accuracy.

“Because the GA level is measured quickly and is a reliable marker for predicting SHT, monitoring prestroke glycaemic variability via GA levels may be helpful to establish strategies for the prevention of SHT and poor functional outcomes in acute stroke patients receiving IVT,” the researchers said.