The effectiveness and safety of human urinary kallidinogenase in acute ischemic stroke patients undergoing endovascular therapy.

IF 4.9 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2024-09-01 Epub Date: 2024-03-09 DOI:10.1177/0271678X241238033

Mengmeng Wang, Changwei Guo, Jie Yang, Jing Li, Jinrong Hu, Zhouzhou Peng, Meng Guo, Lingyu Zhang, Fengli Li, Qingwu Yang, Wenjie Zi, Pengfei Wang

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Abstract

The effectiveness and safety of human urinary kallidinogenase (HUK) in acute ischemic stroke (AIS) patients undergoing endovascular therapy (EVT) due to large vessel occlusion (LVO) was unclear. A pooled analysis was performed using individual data from the DEVT and RESCUE BT trials. Patients were divided into two groups based on HUK treatment. The primary outcome was the 90-day modified Rankin Scale (mRS) score. Safety outcomes included 90-day mortality and symptomatic intracranial hemorrhage (sICH) within 48 hours. A total of 1174 patients were included in the study. Of these, 150 (12.8%) patients received HUK. The adjusted common odds ratio (OR) of the mRS score was 1.458 (95% confidence interval [CI] = 1.072-1.983; p = 0.016) favoring HUK. The incidence of sICH (2.0% vs. 8.6%; adjusted OR: 0.198; 95% CI: 0.061-0.638; p = 0.007) and mortality (11.3% vs.18.5%; adjusted OR: 0.496; 95% CI: 0.286-0.862; p = 0.013) was lower in HUK group than non-HUK group. This association was consistent with propensity score-matching and the inverse probability of treatment weighting analysis. In conclusion, HUK was safe and associated with a preferable prognosis in AIS patients due to LVO in the anterior circulation.

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接受血管内治疗的急性缺血性脑卒中患者服用人尿液凯利苷原酶的有效性和安全性。

对于因大血管闭塞（LVO）而接受血管内治疗（EVT）的急性缺血性卒中（AIS）患者，人尿凯利苷原酶（HUK）的有效性和安全性尚不明确。我们利用 DEVT 和 RESCUE BT 试验的个别数据进行了汇总分析。根据 HUK 治疗将患者分为两组。主要结果是 90 天改良 Rankin 量表（mRS）评分。安全性结果包括90天死亡率和48小时内无症状性颅内出血（sICH）。研究共纳入了 1174 名患者。其中 150 例（12.8%）患者接受了 HUK 治疗。调整后的 mRS 评分共同几率比 (OR) 为 1.458（95% 置信区间 [CI] = 1.072-1.983；P = 0.016），HUK 更受青睐。HUK 组的 sICH 发生率（2.0% 对 8.6%；调整 OR：0.198；95% CI：0.061-0.638；p = 0.007）和死亡率（11.3% 对 18.5%；调整 OR：0.496；95% CI：0.286-0.862；p = 0.013）均低于非 HUK 组。这种关联与倾向评分匹配和治疗加权逆概率分析结果一致。总之，对于因前循环低左室血流阻塞而导致的 AIS 患者，HUK 是安全的，且预后较好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cerebral Blood Flow and Metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.80%

发文量

300

审稿时长

3 months

期刊介绍： JCBFM is the official journal of the International Society for Cerebral Blood Flow & Metabolism, which is committed to publishing high quality, independently peer-reviewed research and review material. JCBFM stands at the interface between basic and clinical neurovascular research, and features timely and relevant research highlighting experimental, theoretical, and clinical aspects of brain circulation, metabolism and imaging. The journal is relevant to any physician or scientist with an interest in brain function, cerebrovascular disease, cerebral vascular regulation and brain metabolism, including neurologists, neurochemists, physiologists, pharmacologists, anesthesiologists, neuroradiologists, neurosurgeons, neuropathologists and neuroscientists.