Paradoxical effect of obesity on hemorrhagic transformation after acute ischemic stroke

Cited 16 time in Web of Science Cited 17 time in Scopus

Kim, Chi Kyung; Ryu, Wi-Sun; Kim, Beom Joon; Lee, Seung-Hoon

Issue Date
BioMed Central Ltd.
BMC Neurology Vol.13 No.1, pp.123-128
ObesityHemorrhagic transformationBleeding-obesity paradoxIschemic strokeBody mass index
Background : Among the patients with established coronary artery diseases, obese patients tend to have a more favorable prognosis, which is called as obesity paradox. Interestingly, mildly obese patients who underwent coronary revascularization had a lower risk of bleeding. In this context, we have investigated the association between obesity and hemorrhagic transformation (HTf) after acute ischemic stroke.
Methods : A total of 365 patients with first-ever acute ischemic stroke were included in this study. Demographic, clinical and radiological information was collected and HTf was evaluated through follow-up T2*-weighted gradient-recalled echo MRI performed usually within 1week after occurrence of stroke. Body mass index was calculated, and obesity was defined using the World Health Organization Western Pacific Regional Office criteria.
Results : The HTf was identified in 59 patients (16.2%). As the severity of obesity increased, the occurrence of HTf decreased. Compared with the normal weight group and after controlling possible confounders including acute and previous treatment, stroke severity and subtype, the risk of HTf decreased significantly in the obese group (odds ratio, 0.39; 95% confidence interval, 0.17-0.87).
Conclusions : The better outcome for HTf seen in obese patients suggests the existence of a bleeding-obesity paradox in acute ischemic stroke.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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