Serum Ferritin Level - A Predictor of Hemorrhagic Transformation in Acute Ischaemic Stroke
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 1
Abstract
Introduction: Hemorrhagic transformation (HT) in acute ischemic stroke (AIS) is associated with significant morbidity and mortality. High serum ferritin has been claimed to be associated with HT. This study investigated whether AIS patients having high serum ferritin level are at increased risk of hemorrhagic transformation. Material and Methods: Patients with acute ischemic stroke presenting within 48 hours of onset of symptoms were included in the study. Detailed clinical, laboratory and radiological evaluation was done. All patients were evaluated for hemorrhagic transformation of the infarct over a five days period. Results: One hundred twenty one patients with AIS were enrolled in the study. CT/MRI showed HT in 10 patients. Serum ferritin level with HT was independent with gender, age, tobacco use. The critical level of serum ferritin was taken as 161.89ng/ml, which was the minimum ferritin level in HT patients in this study. Among patients with hemorrhagic transformation having serum ferritin level above the critical level, the relative risk of HT to male was 2.25 which demonstrated that male patients having serum ferritin above critical value are more prone to develop HT than females. Patients with diabetes mellitus were more at risk than non-DM ones. It was observed that the mean of serum ferritin among patients with diabetics (132.97) was higher than the mean of non diabetic patients (117.95). The relationship between diabetics, non diabetics and serum ferritin was statistically significant (p =0.048). Conclusion: This study substantiated the observations of previous research, that higher level of serum ferritin (within the normal physiological range) is correlated with higher conversion to HT in AIS patients, and can be used as a predictor, it is not a strong predictor alone. It becomes a strong predictor in combination of T2DM and HTN. The study opened the vista that in cases of AIS, history of T2DM and HTN should be taken into consideration along with measuring serum ferritin, and those cases having all three factors should be observed more diligently and frequently for development of HT.
Authors and Affiliations
Reshma Kaushik, Manish Mittal, Abhijeet Gupta
Keywords
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