Abstract Details Title Increased Total Bilirubin Levels are Associated with Hemorrhagic Transformation in Patients with Acute Ischemic Stroke Topic Cerebrovascular Disease and Interventional Neurology Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM) Poster/Presentation Number 4-011 Objective Our aim was to investigate the association between the total bilirubin (TBIL) levels and hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS). Background HT is a severe but common complication in patients with AIS. Recent studies have found that bilirubin is a marker of oxidative stress and is associated with the integrity of blood-brain barrier. Design/Methods The study included 247 consecutive AIS patients with HT and 247 age- and sex-matched stroke patients without HT. All patients were divided into quartiles according to the distribution of baseline TBIL levels. HT was classified as hemorrhagic infarction (HI) or parenchymal hematoma (PH) based on follow-up magnetic resonance imaging or computed tomography. Results In this study, the optimal cut-off points of TBIL were: (Q1) 4.0-9.0 μmol/L, (Q2) 10.0-13.0 μmol/L, (Q3) 14.0-20.0 μmol/, (Q4) 21.0-39.0 μmol/L. Baseline TBIL levels were significantly higher in the HT patients than in the non-HT patients (P < 0.001). The proportion of patients with severe HT (PH, 53.8%) in the Q4 was greater than the proportion with mild HT (HI, 15.6%) and without HT (14.6%). Furthermore, HT severity increased as the TBIL level increased (P < 0.001). We found the highest (Q4) and the second highest quartile (Q3) of TBIL were independently associated with HT in AIS patients (OR = 4.925, 95% CI = 2.648–9.160; OR = 2.380, 95% CI = 1.326–4.275 respectively) after adjustment for conventional and significant confounding factors. Conclusions Our results suggested that increased serum levels of TBIL at admission is independently associated with a high risk of HT after stroke. This finding may help clinicians identify patients at high risk of HT and initiate early therapy. Authors/Disclosures PRESENTER No disclosure on file No disclosure on file