Early plasma YKL40 level is associated with 3-month functional outcome in ischemic stroke patients treated with endovascular therapy

Q3 Medicine

Morphologie Pub Date : 2024-11-26 DOI:10.1016/j.morpho.2024.100873

Claire Paquet

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引用次数: 0

Abstract

Introduction

More than 40% of large vessel occlusion ischemic stroke patients remain disabled at 3 months despite successful reperfusion therapies including intravenous thrombolysis and endovascular therapy (EVT). This neurological disability is mainly due to sensori-motor sequelae and post-stroke cognitive impairment (PSCI). Glycoprotein YKL40 is a biomarker of astrocytic and microglial activation. It is elevated in plasma in numerous neurodegenerative disorders but also in acute ischemic stroke. We hypothesized that acute microglial inflammation plays a key role in PSCI and that plasma levels of YKL40 in acute stroke could be a predictive biomarker of future cognitive and functional outcomes.

Methods

Monocentric prospective study included patients treated with EVT, for whom 3 blood samples (before, within 1 h, 24 h post-EVT) were drawn to measure plasma YKL40 concentrationas a marker of microglial activation. Excellent outcome was defined as a modified Rankin scale (mRS) between 0–1 at 3 months.

Results

We included 120 patients between 2016–2020. Median NIHSS was 17 and median ASPECT score was 7. Reperfusion was achieved at a mean delay of 5 h 44. After three months, median mRS was 3 and 25% of patients with pre-stroke mRS < 2 had excellent outcome.

Excellent clinical outcome was significantly associated with plasma YKL40 levels (P = 0.001) after adjustment on age, NIHSS and delay since onset.

Discussion

Plasma YKL40 is a candidate predictor of the functional outcome at 3 months in ischemic stroke treated by EVT. This novel biomarker of stroke could allow optimizing rehabilitation after a stroke and give new insight on pathophysiology of PSCI.

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早期血浆 YKL40 水平与接受血管内治疗的缺血性脑卒中患者 3 个月的功能预后有关

导言尽管静脉溶栓和血管内治疗（EVT）等再灌注疗法取得了成功，但40%以上的大血管闭塞性缺血性卒中患者在3个月后仍会致残。这种神经残疾主要是由于感觉运动后遗症和卒中后认知障碍（PSCI）造成的。糖蛋白 YKL40 是星形胶质细胞和小胶质细胞活化的生物标志物。它在许多神经退行性疾病的血浆中都会升高，但在急性缺血性中风中也会升高。我们假设，急性微神经胶质细胞炎症在 PSCI 中起着关键作用，急性卒中血浆中的 YKL40 水平可作为未来认知和功能预后的预测性生物标志物。方法单中心前瞻性研究纳入了接受 EVT 治疗的患者，对其抽取 3 份血液样本（EVT 前、EVT 后 1 小时内和 24 小时内），测量血浆中作为微神经胶质细胞活化标志物的 YKL40 浓度。结果我们在2016-2020年间纳入了120名患者。NIHSS 中位数为 17，ASPECT 中位数为 7。三个月后，中位 mRS 为 3，25% 的卒中前 mRS 为 2 的患者获得了良好的预后。在对年龄、NIHSS 和发病延迟进行调整后，良好的临床预后与血浆 YKL40 水平显著相关（P = 0.001）。这种新的卒中生物标志物可优化卒中后的康复，并为 PSCI 的病理生理学提供新的见解。

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

Morphologie Medicine-Anatomy

CiteScore

2.30

自引率

0.00%

发文量

150

审稿时长

25 days

期刊介绍： Morphologie est une revue universitaire avec une ouverture médicale qui sa adresse aux enseignants, aux étudiants, aux chercheurs et aux cliniciens en anatomie et en morphologie. Vous y trouverez les développements les plus actuels de votre spécialité, en France comme a international. Le objectif de Morphologie est d?offrir des lectures privilégiées sous forme de revues générales, d?articles originaux, de mises au point didactiques et de revues de la littérature, qui permettront notamment aux enseignants de optimiser leurs cours et aux spécialistes d?enrichir leurs connaissances.