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image of Risk Factors for Symptomatic Intracerebral Hemorrhage in Individuals with Prior Cerebral Infarction

Abstract

Introduction

This study aims to identify risk factors for symptomatic intracerebral hemorrhage (ICH) in patients with old cerebral infarction.

Methods

A retrospective cohort study was conducted at Jining First People's Hospital between January 2022 and May 2024, including 287 individuals with a history of prior cerebral infarction. Study participants were classified into two groups based on the presence of symptomatic hemorrhage: those with ICH ( = 96) and those without ICH ( = 191). Logistic regression analysis was employed to identify risk factors associated with cerebral hemorrhage occurring after cerebral infarction in this population.

Results

The incidence of ICH among individuals with prior cerebral infarction was 33.48% (96/287 cases). Univariate regression analysis revealed significant differences between the ICH and the non-ICH groups in alcohol consumption, hypertension, hyperlipidemia, statin therapy, antiplatelet therapy, systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin, platelet-to-lymphocyte ratio, and cerebral microbleeds (CMBs). Multivariate logistic regression analysis revealed that CMB, alcohol consumption, hyperlipidemia, and statin treatment were independent predictors of ICH in individuals with prior cerebral infarction. Additionally, CMB severity was significantly positively correlated with ICH occurrence.

Discussion

In prior cerebral infarction, CMBs, alcohol history, hyperlipidemia, and statin use independently predicted subsequent ICH, with risk escalating sharply as the CMB grade rose. These findings highlight the need to weigh aggressive lipid-lowering and antiplatelet therapy against the hemorrhagic threat signaled by CMBs and modifiable lifestyle factors.

Conclusion

The development of ICH in individuals with prior cerebral infarction is influenced by multiple factors. Effective management of CMBs, control of hyperlipidemia, alcohol abstinence, and careful adjustment of statin therapy are critical for preventing ICH. CMB severity emerges as a particularly strong predictor of ICH risk.

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2025-12-30
2026-01-25

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References

  1. Zhao Y. Zhang X. Chen X. Wei Y. Neuronal injuries in cerebral infarction and ischemic stroke: From mechanisms to treatment (Review). Int. J. Mol. Med. 2021 49 2 15 10.3892/ijmm.2021.5070 34878154
    [Google Scholar]
  2. Al-Kawaz M.N. Hanley D.F. Ziai W. Advances in therapeutic approaches for spontaneous intracerebral hemorrhage. Neurotherapeutics 2020 17 4 1757 1767 10.1007/s13311‑020‑00902‑w 32720246
    [Google Scholar]
  3. Martínez Camblor L. Peña Suárez J.M. Martínez-Cachero García M. Santamarta Liébana E. Rodríguez Castro J. Saiz Ayala A. Cerebral microbleeds. Utility of SWI sequences. Radiología 2023 65 4 362 375 10.1016/j.rxeng.2022.12.006 37516489
    [Google Scholar]
  4. Akoudad S. Portegies M.L.P. Koudstaal P.J. Cerebral microbleeds are associated with an increased risk of stroke. Circulation 2015 132 6 509 516 10.1161/CIRCULATIONAHA.115.016261 26137955
    [Google Scholar]
  5. Zhong D. Zhang S.T. Wu B. Interpretation of “Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018”. Chin J Mod Neurol Dis 2019 19 11 897 901
    [Google Scholar]
  6. Niu T.T. Niu J.Z. Liu G.Z. Analysis of risk factors associated with cerebral microbleeds in ischemic stroke. Chin J Neuroimmunol Neurol 2023 30 4 233 238
    [Google Scholar]
  7. Hu Q. Manaenko A. Bian H. Hyperbaric oxygen reduces infarction volume and hemorrhagic transformation through ATP/NAD+/sirt1 pathway in hyperglycemic middle cerebral artery occlusion rats. Stroke 2017 48 6 1655 1664 10.1161/STROKEAHA.116.015753 28495827
    [Google Scholar]
  8. Kong L.W. Wang Q. Lv K. Clinical characteristics and risk factors of hemorrhagic transformation in patients with cerebral infarction. Med Pharm J Chin People’s Liberation Army 2021 33 8 101 104
    [Google Scholar]
  9. Yang N. Lin M. Wang B.G. Low level of low-density lipoprotein cholesterol is related with increased hemorrhagic transformation after acute ischemic cerebral infarction. Eur. Rev. Med. Pharmacol. Sci. 2016 20 4 673 678 26957269
    [Google Scholar]
  10. Yang Y. Huang Z. Zhang X. Efficacy and safety of clopidogrel and/or aspirin for ischemic stroke/transient ischemic attack. Medicine 2021 100 50 e27804 10.1097/MD.0000000000027804 34918630
    [Google Scholar]
  11. Amarenco P. Bogousslavsky J. Callahan A. High-dose atorvastatin after stroke or transient ischemic attack. N. Engl. J. Med. 2006 355 6 549 559 10.1056/NEJMoa061894 16899775
    [Google Scholar]
  12. Lv G. Wang G. Xia Z. Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: A case-control study of 732 patients. Mil. Med. Res. 2019 6 1 2 10.1186/s40779‑019‑0191‑z 30665465
    [Google Scholar]
  13. Goldstein L.B. Amarenco P. LaMonte M. Relative effects of statin therapy on stroke and cardiovascular events in men and women: Secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Study. Stroke 2008 39 9 2444 2448 10.1161/STROKEAHA.107.513747 18617654
    [Google Scholar]
  14. Yang Q. Yang Y. Li X. Related factors of cerebral hemorrhage after cerebral infarction and the effect of atorvastatin combined with intensive nursing care. Comput. Math. Methods Med. 2022 2022 1 7 10.1155/2022/9546006 35959354
    [Google Scholar]
  15. Jolink W.M.T. Wiegertjes K. Rinkel G.J.E. Algra A. de Leeuw F.E. Klijn C.J.M. Location-specific risk factors for intracerebral hemorrhage. Neurology 2020 95 13 e1807 e1818 10.1212/WNL.0000000000010418 32690784
    [Google Scholar]
  16. Zeng Z. Chen J. Qian J. Ma F. Lv M. Zhang J. Risk factors for anticoagulant-associated intracranial hemorrhage: A systematic review and meta-analysis. Neurocrit. Care 2023 38 3 812 820 10.1007/s12028‑022‑01671‑4 36670269
    [Google Scholar]
  17. Chen L. Liu F. Tian X. Zhang T. Zhang J. Ran F. Impact of cerebral microbleeds on cognitive functions and its risk factors in acute cerebral infarction patients. Neurol. Res. 2023 45 6 564 571 10.1080/01616412.2022.2164456 36621968
    [Google Scholar]
  18. Wang B. Yang N. Lin M. Lu B. Analysis of risk factors of hemorrhagic transformation after acute ischemic stroke: Cerebral microbleeds do not correlate with hemorrhagic transformation. Cell Biochem. Biophys. 2014 70 1 135 142 10.1007/s12013‑014‑9869‑8 24691925
    [Google Scholar]
  19. Mok V. Kim J.S. Prevention and management of cerebral small vessel disease. J. Stroke 2015 17 2 111 122 10.5853/jos.2015.17.2.111 26060798
    [Google Scholar]
/content/journals/cnr/10.2174/0115672026429083251210062440
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Risk Factors for Symptomatic Intracerebral Hemorrhage in Individuals with Prior Cerebral Infarction
Bentham Science Publishers ; https://doi.org/10.2174/0115672026429083251210062440
/content/journals/cnr/10.2174/0115672026429083251210062440
/content/journals/cnr/10.2174/0115672026429083251210062440
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  • Article Type:     Research Article
Keywords: prevention ; risk factors ; cerebral small vessel disease ; prior cerebral infarction ; Cerebral microbleeds ; intracerebral hemorrhage

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