Serum Albumin Is Associated with Cerebral Hemorrhage in Post-Intravenous Thrombolytic Therapy for Acute Stroke : A Retrospective Chart Review (P4.222)

OBJECTIVE: Serum Albumin is Associated with Cerebral Hemorrhage in Post-Intravenous Thrombolytic Therapy for Acute Stroke BACKGROUND The use of IV thrombolysis remains low in the treatment of acute stroke. Only 5-8% of acute strokes are given IV tPA. A common fear among physicians remains the risk of conversion. Many studies have unsuccessfully looked at factors involved in this risk. Recent literature indicates that circulating protein albumin may have an effect on blood brain barrier integrity at the level of the endothelial cell, which along with the closely associated astrocyte and podocyte together represent the cells responsible for maintaining the blood brain barrier. Albumin appears to strengthen the tightly associated cell junctions and interactions at the center of blood brain barrier integrity. The ALIAS II trail failed to show a clinical benefit of albumin administration in acute stroke in both patients treated and not treated with thrombolytics, they did not investigate whether albumin was protective against hemorrhagic conversion; they only noted that the albumin treated group (containing both IV tpa and non-IV tpa treated groups) and those not treated with albumin (again also containing both non and thrombolytic groups) were no different in hemorrhage rates. METHODS A retrospective chart review of consecutive acute stroke patients treated with IV thrombolytics was obtained. We also noted the admission serum albumin level on these patients. Neuroimaging data at 24hrs, either CT or MRI, including the presence of any hemorrhage was collected. RESULTS The average albumin level in the non-hemorrhage group was 4.032. The average albumin in the group with the presence of hemorrhage was 3.693. The difference in means was statistically significant using the t-test(p Study Supported by: none Disclosure: Dr. Kamal has nothing to disclose. Dr. Li has nothing to disclose. Dr. Smith has nothing to disclose. Dr. Mustafa has nothing to disclose. Dr. Sawyer has nothing to disclose. Dr. Ching has nothing to disclose. Dr. Mehta has received personal compensation for activities with Biogen Idec, and Teva Neuroscience as a speaker, and with the Gerson Lehrman Group as a consultant.