DOI: 10.12688/f1000research.181550.1 ISSN: 2046-1402

Risk Factor on Bleeding Event after Intravenous Alteplase Therapy in Acute Ischaemic Stroke

Thariqa Haya Razak, Fita Rahmawati, Agung Endro Nugroho, Megasukma Muduri Armala, Putu Wida Kawistari, Lucia Shinta Ratnaningtyas
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Background Bleeding is a serious complication of alteplase therapy for acute ischaemic stroke. A bleeding event can increase mortality and re-current stroke. The aim of this study is to analyze the early warning index of bleeding complications after reperfusion therapy with alteplase. Methods This research was a retrospective study. The clinical data of acute ischaemic stroke patients receiving alteplase were collected at Gadjah Mada University Academic Hospital, Indonesia, from January 2020 to October 2025. The data collected in this study included blood pressure measurements, blood glucose levels triglyceride levels, the patient’s state of consciousness, and information about the patient’s history of chronic illness such as diabetes mellitus, hypertension, dyslipidemia, heart failure, atrial fibrillation, prior stroke, and antiplatelet use were among the data gathered for this study. Data analysis involved bivariate analysis using the chi-square/Fischer’s exact test or independent sample t-test/Mann-Whitney test to determine the interaction between risk factors and the incidence of bleeding in patients with acute ischaemic stroke. To find independent risk factors for bleeding, which are defined as an OR > 1 and P < 0.05, a multivariate logistic regression analysis is performed. Results A total of 81 patients using alteplase were included in this study, of which, the bleeding group had 26 (32.09%) cases and the non-bleeding had 55 (76.91%) cases. Of these, 8 (9.88%) had serious bleeding and 18 (22.22%) had minor bleeding. The results showed that the majority of subjects were male, with a mean age of 62.38 years. The variables linked with a substantial variation in the incidence of bleeding were blood glucose levels (p = 0.11) and triglyceride levels (p = 0.002). Blood glucose level was an independent risk factor for bleeding after alteplase therapy, with an OR 0f 1.01 (95% CI 1.003–1.019, p = 0.008).

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