Hypersensitive C-Reactive Protein-Albumin Ratio Predicts Symptomatic Intracranial Hemorrhage After Endovascular Therapy in Acute Ischemic Stroke Patients

Abstract

Background and purpose: A fraction of patients would develop symptomatic intracranial hemorrhage (sICH) after endovascular therapy. The aim of our study was to explore the ability of hypersensitive C-reactive protein-albumin ratio (HAR) in predicting sICH after endovascular therapy.Methods: From April 2016 to December 2018, 334 consecutive patients with anterior circulation infarction undergoing endovascular therapy were enrolled in our study. sICH was defined as a National Institutes of Health Stroke Scale score increase of ≥ 4 points within 24 hours after endovascular therapy. Multiple regression analysis was used to investigate the potential risk factors of sICH after endovascular therapy. We used receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the HAR in predicting sICH after endovascular therapy.Results: Among these 334 patients enrolled, 37 (11.1%) patients with anterior circulation infarction were identified with sICH after endovascular therapy. Univariate logistic regression analysis demonstrated that patients with higher levels of HAR may be inclined to develop sICH [odds ratio, 10.994; 95% confidence interval (CI), 4.567–26.463; P = 0.001]. This association remained significant even after adjustment for potential confounders. Also, a cutoff value of 0.526×10-3 for HAR was detected in predicting sICH (area under curve, 0.763). Furthermore, nomogram analysis also suggested that HAR was an indicator of sICH (c-index was 0.890, P<0.001).Conclusions: This study showed that high levels of HAR may predict sICH after endovascular therapy.