Abstract

Background: This study aimed to investigate the correlation between early thrombelastography (TEG) and serum Homer1 with hemorrhagic transformation (HT) after intravenous thrombolysis (IVH) in acute ischemic stroke (AIS).
Methods: This prospective cohort study was conducted from January 2021 to December 2023. TEG parameters and serum Homer1 levels were measured after IVH treatment. Baseline clinical factors were constructed using multifactor logistic regression analysis (Model 1). Subsequently, TEG parameters and serum Homer1 were incorporated into Model 1 to construct Models 2 and 3, respectively, for predicting HT after AIS. The predictive value of the three models was evaluated by using ROC curves.
Results: A total of 221 patients with AIS (40 cases with HT and 181 cases without HT) and 40 controls were included in this study. Reaction time of blood coagulation (R) was significantly higher in the HT group (6.65 vs. 5.50) than in the non-HT group (p < 0.001). Maximal amplitude (MA) was significantly lower in the HT group (61.28 vs. 64.94) than in the non-HT group (p < 0.001). Serum levels were significantly higher in AIS patients (20.73 vs. 38.43) than in controls (p < 0.001). Serum Homer1 levels were higher in patients in the HT group (54.35 vs. 37.43) than in non-HT patients (p < 0.001). Baseline NIHSS, prolonged coagulation reaction time R, and increased serum Homer1 levels were risk factors for post-thrombolytic HT in patients with AIS, whereas elevated Hgb was a protective factor. Both the construction of a model to predict the risk of post-thrombolytic HT in pa¬tients with AIS using clinical factors and the combination of clinical factors with TEG parameters (or serum Homer1) had similar predictive value (p < 0.05).
Conclusions: Measurement of TEG parameters and Homer1 levels in patients with AIS early after IVH may be a potentially useful, relatively rapid, and minimally invasive method for predicting the risk of HT in patients with AIS.

DOI: 10.7754/Clin.Lab.2024.240740