Cerebrovascular Diseases Extra最新文献

{"title":"Clopidogrel-Related High Residual Platelet Reactivity Associated with Estimated Glomerular Filtration Rate in Patients with Acute Ischemic Stroke.","authors":"Yongkang Zhang, Yuan Zong, Jiarui Liu, Kangli Yin, Yuzhen Wang, Yuefeng Bian, Yichen Huang, Wei Liu, Yemin Cao","doi":"10.1159/000534466","DOIUrl":"10.1159/000534466","url":null,"abstract":"<p><strong>Introduction: </strong>There are few studies on the relationship between the occurrence of clopidogrel-related high residual platelet reactivity (HRPR) and estimated glomerular filtration rate (eGFR) at admission in patients with ischemic stroke. The aim of this study was to investigate the possible relationship between the two.</p><p><strong>Methods: </strong>Patients who were hospitalized and diagnosed with acute ischemic stroke were recruited from July 1, 2017, to June 30, 2018, at Shanghai TCM-Integrated Hospital. Renal function was measured within 24 h of enrollment and eGFR was calculated. Patients were tested for platelet reactivity using the VerifyNow system after 7 days of antiplatelet therapy with clopidogrel 75 mg/d alone, and patients with P2Y12 reaction unit values ≥230 were diagnosed with HRPR. The association between HRPR and eGFR was analyzed.</p><p><strong>Results: </strong>A total of 274 patients were enrolled in the study, of whom 91 (33.21%) had HRPR. Multivariate logistic regression analysis suggested that an increased risk of HRPR was independently associated with female sex and reduced eGFR (female sex: OR = 2.24, 95% CI: 1.26-3.99, p = 0.006; mild chronic kidney disease [CKD]: OR = 2.95, 95% CI: 1.47-5.93, p = 0.002; moderate CKD: OR = 3.07, 95% CI: 1.08-8.75, p = 0.04).</p><p><strong>Conclusion: </strong>Decreased eGFR is an independent risk factor for the occurrence of HRPR in patients with ischemic stroke.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"83-89"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10620003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41183845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Histopathological Thrombus Age in Large Vessel Occlusion-Related Stroke.","authors":"Bart Van Gorsel, Michel J M Remmers, Louwerens D Vos, Bas E Scholzel, Dirk A W Haans, Ruud A H M Aarts, Rob J Versteylen, Anouk G W Van Norden, Casper A M M Van Oers, Jeroen Vos, Sander J J IJsselmuiden, Ben J L Van Den Branden, Onno J De Boer, Farshad Imani, Marco Alings, Kartika R Pertiwi, Robbert J De Winter, Ishita Miah, Allard C Van Der Wal, Tim P Van De Hoef, Martijn Meuwissen","doi":"10.1159/000534937","DOIUrl":"10.1159/000534937","url":null,"abstract":"<p><strong>Introduction: </strong>Acute mechanical thrombectomy (MT) is the preferred treatment for large vessel occlusion-related stroke. Histopathological research on the obtained occlusive embolic thrombus may provide information regarding the aetiology and pathology of the lesion to predict prognosis and propose possible future acute ischaemic stroke therapy.</p><p><strong>Methods: </strong>A total of 75 consecutive patients who presented to the Amphia Hospital with acute large vessel occlusion-related stroke and underwent MT were included in the study. The obtained thrombus materials were subjected to standard histopathological examination. Based on histological criteria, they were considered fresh (&lt;1 day old) or old (&gt;1 day old). Patients were followed for 2 years for documentation of all-cause mortality.</p><p><strong>Results: </strong>Thrombi were classified as fresh in 40 patients (53%) and as older in 35 patients (47%). Univariate Cox regression analysis showed that thrombus age, National Institutes of Health Stroke Scale at hospital admission, and patient age were associated with long-term mortality (p &lt; 0.1). Multivariable Cox hazards and Kaplan-Meier analysis demonstrated that after extensive adjustment for clinical and procedural variables, thrombus age persisted in being independently associated with higher long-term mortality (hazard ratio: 3.34; p = 0.038, log-rank p = 0.013).</p><p><strong>Conclusion: </strong>In this study, older thromboemboli are responsible for almost half of acute large ischaemic strokes. Moreover, the presence of an old thrombus is an independent predictor of mortality in acute large vessel occlusion-related stroke. More research is warranted regarding future therapies based on thrombus composition.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"97-104"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Cerebral Venous Thrombosis-Risk Factors, Clinical Course, and Outcome in Subjects with and without COVID-19 Infection.","authors":"Sajid Hameed, Anwar Hamza, Bushra Taimuri, Maria Khan, Man Mohan Mehndiratta, Mohammad Wasay","doi":"10.1159/000530819","DOIUrl":"10.1159/000530819","url":null,"abstract":"<p><strong>Background/objective: </strong>Cerebral venous thrombosis (CVT) has been increasingly reported in patients with COVID-19. Most published literature is descriptive and focuses only on CVT in COVID-19 patients. The objective of our study was to compare CVT patients' characteristics with and without an associated COVID-19 infection.</p><p><strong>Materials and methods: </strong>This is a retrospective cross-sectional study. All adult patients with a confirmed diagnosis of CVT admitted to our hospital over a period of 30 months, from January 2019 to June 2021, were included. They were further divided into two groups, with and without COVID-19 infection.</p><p><strong>Results: </strong>A total of 115 CVT patients were included, 93 in non-COVID-CVT and 22 in COVID-CVT group. COVID-CVT patients were male predominant and of older age, with longer hospital stay, and higher inpatient mortality. COVID-CVT patients presented with a higher frequency of headache (82% vs. 63%), seizures (64% vs. 37%, p = 0.03), hemiparesis (41% vs. 24%), and visual changes (36% vs. 19%) as compared to non-COVID-CVT patients. Venogram showed a higher frequency of superior sagittal sinus (64% vs. 42%) and internal jugular vein (23% vs. 12%) involvement in the COVID-CVT cohort. More than 90% of patients in both groups received therapeutic anticoagulation. Mortality rates were higher in COVID-CVT group (18% vs. 11%).</p><p><strong>Conclusion: </strong>COVID-CVT patients were male predominant and of older age, with higher hospital stay, and higher inpatient mortality as compared to non-COVID-CVT patients.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"63-68"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10102067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Patency of the Carotid Terminus and Middle Cerebral Artery on Early Clinical Outcomes in Patients with Acute Internal Carotid Artery Occlusion and Mild Symptoms.","authors":"Ryo Itabashi, Takuya Saito, Yuichi Kawabata, Yuya Kobayashi, Yukako Yazawa","doi":"10.1159/000527635","DOIUrl":"10.1159/000527635","url":null,"abstract":"<p><strong>Introduction: </strong>Both collateral flow via the internal carotid artery (ICA) terminus (ICT) and initial mild symptoms might be associated with favorable outcomes in patients with acute ICA occlusion (ICAO). This study aimed to address the association between early clinical outcomes and patency of the ICT and middle cerebral artery (MCA) in patients with acute ICAO with mild symptoms.</p><p><strong>Methods: </strong>Of 1,214 consecutive patients with acute ischemic stroke or transient ischemic attack due to large vessel occlusion, patients with ipsilateral ICAO and initial National Institutes of Health Stroke Scale (NIHSS) score ≤5 were retrospectively enrolled. We examined the associations between clinical factors including patency of the ICT and MCA and recurrence of stroke or early neurological deterioration (REND). Significant early neurological deterioration was defined as increment in NIHSS score ≥1 during hospital stay.</p><p><strong>Results: </strong>Thirteen of the 35 patients who were finally enrolled had REND (37%), and median modified Rankin scale (mRS) score at discharge was 1 (interquartile range, 0-4). Initial NIHSS score (4 vs. 1, p < 0.001) and rates of diabetes mellitus (61.5% vs. 13.6%, p = 0.007), intravenous thrombolysis (IVT) (30.9% vs. 0%, p = 0.014), and mechanical thrombectomy (MT) (23.1% vs. 0%, p = 0.044) were significantly higher in patients with REND rather than in those without. The rate of patent ICT and MCA was comparable between groups. Except for 1 patient who underwent MT promptly after IVT immediately after REND, 3 patients initially treated with IVT deteriorated after the procedure. One patient without patent ICT and MCA did not meet the indications for MT. In 2 other patients with patent ICT and MCA, MT was not initially performed, but was eventually performed because of REND due to thrombus migration, and both were discharged with an mRS score of 5.</p><p><strong>Conclusion: </strong>The overall clinical outcomes of patients with acute ICAO with mild symptoms were not depending on the patency of the ICT and MCA, but initial treatment with IVT alone might risk unfavorable outcomes due to thrombus migration in patients with patent ICT and MCA.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/f1/cee-0013-0001.PMC9843553.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10538828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Atrial Fibrillation after Ischemic Stroke: Clinical, Genetics, and Electrocardiogram Modelling.","authors":"Mervyn Qi Wei Poh, Carol Huilian Tham, Jeremiah David Ming Siang Chee, Seyed Ehsan Saffari, Kenny Wee Kian Tan, Li Wei Tan, Ebonne Yulin Ng, Celestia Pei Xuan Yeo, Christopher Ying Hao Seet, Joanne Peiting Xie, Jonathan Yexian Lai, Rajinder Singh, Eng-King Tan, Tian Ming Tu","doi":"10.1159/000528516","DOIUrl":"10.1159/000528516","url":null,"abstract":"<p><strong>Introduction: </strong>Detection of atrial fibrillation (AF) is challenging in patients after ischaemic stroke due to its paroxysmal nature. We aimed to determine the utility of a combined clinical, electrocardiographic, and genetic variable model to predict AF in a post-stroke population.</p><p><strong>Materials and methods: </strong>We performed a cohort study at a single comprehensive stroke centre from November 09, 2009, to October 31, 2017. All patients recruited were diagnosed with acute ischaemic stroke or transient ischaemic attacks. Electrocardiographic variables including p-wave terminal force (PWTF), corrected QT interval (QTc), and genetic variables including single nucleotide polymorphisms (SNPs) at the 4q25 (rs2200733) were evaluated. Clinical, electrocardiographic and genetic variables of patients without AF and those who developed AF were compared. Multiple logistic regression analysis and receiver operating characteristics were performed to identify parameters and determine their ability to predict the occurrence of AF.</p><p><strong>Results: </strong>Out of 709 patients (median age of 59 years, inter-quartile range 52-67) recruited, sixty (8.5%) were found to develop AF on follow-up. Age (odds ratio [OR]): 3.49, 95% confidence interval [CI]: 2.03-5.98, p < 0.0001), hypertension (OR: 2.76, 95% CI: 1.36-5.63, p = 0.0052), and valvular heart disease (OR: 8.49, 95% CI: 2.62-27.6, p < 0.004) were the strongest predictors of AF, with an area under receiver operating value of 0.76 (95% CI: 0.70-0.82), and 0.82 (95% CI: 0.77-0.87) when electrocardiographic variables (PWTF and QTc) were added. SNP did not improve prediction modelling.</p><p><strong>Conclusion: </strong>We demonstrated that a model combining clinical and electrocardiographic variables provided robust prediction of AF in our post-stroke population. Role of SNP in prediction of AF was limited.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"9-17"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/f3/cee-0013-0009.PMC10015706.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9118584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study of Application of the Stroke Riskometer Mobile App for Assessment of the Course and Clinical Outcomes of COVID-19 among Hospitalized Patients.","authors":"Alexander Merkin, Sofya Akinfieva, Oleg N Medvedev, Rita Krishnamurthi, Alexey Gutsaluk, Ulf-Dietrich Reips, Rufat Kuliev, Evgeny Dinov, Igor Nikiforov, Nikolay Shamalov, Polina Shafran, Lyudmila Popova, Dmitry Burenchev, Valery Feigin","doi":"10.1159/000529277","DOIUrl":"10.1159/000529277","url":null,"abstract":"<p><strong>Introduction: </strong>Early determination of COVID-19 severity and health outcomes could facilitate better treatment of patients. Different methods and tools have been developed for predicting outcomes of COVID-19, but they are difficult to use in routine clinical practice.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of inpatients aged 20-92 years, diagnosed with COVID-19 to determine whether their individual 5-year absolute risk of stroke at the time of hospital admission predicts the course of COVID-19 severity and mortality. The risk of stroke was determined by the Stroke Riskometer mobile application.</p><p><strong>Results: </strong>We examined 385 patients hospitalized with COVID-19 (median age 61 years). The participants were categorized based on COVID-19 severity: 271 (70.4%) to the \"not severe\" and 114 (29.6%) to the \"severe\" groups. The median risk of stroke the next day after hospitalization was significantly higher among patients in the severe group (2.83, 95% CI: 2.35-4.68) versus the not severe group (1.11, 95% CI: 1.00-1.29). The median risk of stroke and median systolic blood pressure (SBP) were significantly higher among non-survivors (12.04, 95% CI: 2.73-21.19) and (150, 95% CI: 140-170) versus survivors (1.31, 95% CI: 1.14-1.52) and (134, 95% CI: 130-135), respectively. Those who spent more than 2.5 h a week on physical activity were 3.1 times more likely to survive from COVID-19. Those who consumed more than one standard alcohol drink a day, or suffered with atrial fibrillation, or had poor memory were 2.5, 2.3, and 2.6 times more likely not to survive from COVID-19, respectively.</p><p><strong>Conclusions: </strong>High risk of stroke, physical inactivity, alcohol intake, high SBP, and atrial fibrillation are associated with severity and mortality of COVID-19. Our findings suggest that the Stroke Riskometer app could be used as a simple predictive tool of COVID-19 severity and mortality.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"47-55"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/ed/cee-2023-0013-0001-529277.PMC10007710.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9096079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Thrombectomy Treatment More than 16 h after Last Known Well for Patients with Large Vessel Occlusion.","authors":"Takehiro Katano, Kentaro Suzuki, Ryutaro Kimura, Tomonari Saito, Yasuhiro Nishiyama, Kazumi Kimura","doi":"10.1159/000531153","DOIUrl":"10.1159/000531153","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical thrombectomy (MT) has been reported to be effective within 24 h after last known well (LKW) by the DAWN (DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-Up and Late Presenting Strokes Undergoing Neurointervention with Trevo) trial and within 16 h after LKW by the DEFUSE-3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) trial. However, there have been few reports of MT more than 16 h after LKW, and the efficacy and safety of MT more than 24 h after LKW have not yet been demonstrated. We evaluated the efficacy and safety of MT more than 16 h after LKW.</p><p><strong>Methods: </strong>Using data from the Nippon Medical School Hospital MT registry from April 2011 to August 2022, consecutive patients with anterior circulation large vessel occlusion (LVO) and prehospital modified Rankin scale (mRS) scores of 0-3 were enrolled. Patients were classified into the following three groups: early group (LKW &lt;6 h), middle group (LKW 6-16 h), and late group (LKW &gt;16 h). The clinical characteristics and outcomes were compared among these three groups.</p><p><strong>Results: </strong>Among 778 patients in the MT registry, 624 were enrolled. The early group included 432 patients, the middle group included 123 patients, and the late group included 69 patients. The patients had a median age of 77 years (interquartile range, 68-83), and 359 were male (57.5%). The median prehospital mRS score was 1 (interquartile range, 1-1), median National Institutes of Health Stroke Scale score on admission was 17 (interquartile range, 10-23), and median Alberta Stroke Program Early CT Score was 10 (interquartile range, 8-10). Regarding safety and efficacy, the proportions of cases with successful reperfusion (modified Thrombolysis in Cerebral Infarction score of 2b-3; 85.4% vs. 92.7% vs. 88.7%; p = 0.47), symptomatic intracranial haemorrhage (6.4% vs. 5.7% vs. 7.2%; p = 0.99), mRS score ≤3 at 90 days (52.0% vs. 60.2% vs. 44.9%; p = 0.11), and mRS score of 6 at 90 days (11.3% vs. 10.6 vs. 8.7%; p = 0.37) were not significantly different between the three groups.</p><p><strong>Conclusion: </strong>Patients who received MT more than 16 h after LKW experienced the same safety and efficacy as those who received MT at 0-16 h after LKW. MT more than 16 h after LKW may be safe and effective for stroke patients with LVO.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"69-74"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/9a/cee-2023-0013-0001-531153.PMC10601849.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9615254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Characteristics of Spinal Bleeding Sources in Nontraumatic Angiogram-Negative Subarachnoid Hemorrhage.","authors":"Tim Lampmann, Simon Brandecker, Johannes Weller, Frederic Carsten Schmeel, Harun Asoglu, Motaz Hamed, Alexander Radbruch, Erdem Güresir, Hartmut Vatter, Mohammed Banat","doi":"10.1159/000534529","DOIUrl":"10.1159/000534529","url":null,"abstract":"<p><strong>Introduction: </strong>Angiogram-negative subarachnoid hemorrhage (AN-SAH) accounts for 5-15% of spontaneous SAH. This study aims to analyze the frequency and characteristics of spinal bleeding sources in patients with AN-SAH.</p><p><strong>Methods: </strong>140 patients suffering from AN-SAH treated at our institution from 2012 to 2022 were included in this retrospective cohort study.</p><p><strong>Results: </strong>52.1% were diagnosed with perimesencephalic SAH, 35.0% with non-perimesencephalic, SAH and 12.9% with CT-negative SAH (diagnosed by lumbar puncture). Additional magnetic resonance imaging (MRI) identified a spinal bleeding source in 4 patients (2.86%). These patients presented with local spine pain or neurological deficits (relative risk: 3.9706 [95% confidence interval [CI]: 0.7272-21.6792]; p &lt; 0.001) and were younger (mean difference 14.85 years [95% CI: 0.85-28.85; p = 0.038]) compared to patients without a spinal bleeding source.</p><p><strong>Conclusions: </strong>AN-SAH caused by spinal pathology is rare. This study indicates that craniocervical and holospinal MRI should be considered in AN-SAH, especially for young patients with AN-SAH who present with back pain or neurological deficits.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"91-96"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.1159/000534775","DOIUrl":"10.1159/000534775","url":null,"abstract":"","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":"13 1","pages":"90"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10828671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble ST2 Predicts Poor Functional Outcome in Acute Ischemic Stroke Patients.","authors":"Soumya Krishnamoorthy, Gurpreet Singh, Sapna Erat Sreedharan, Deepa Damayanthi, Srinivas Gopala, U K Madhusoodanan, P N Sylaja","doi":"10.1159/000529512","DOIUrl":"10.1159/000529512","url":null,"abstract":"<p><strong>Introduction: </strong>There are very limited data on the role of biomarkers correlating with the outcome in acute ischemic stroke (AIS). We evaluated the predictive values of the plasma concentrations of soluble serum stimulation-2 (sST2), matrix metalloproteinase-9 (MMP-9), and claudin-5 in AIS.</p><p><strong>Methods: </strong>The biomarker levels in the plasma samples of consecutive AIS patients collected at baseline, 12 h, and 24 h from stroke onset were quantified using immunoassays. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and functional outcome at 90 days using the modified Rankin Scale (mRS), with scores above 3 defined as poor outcome. Receiver operating characteristic curve analysis and multiple logistic regression were performed for evaluating the discriminative power of each marker.</p><p><strong>Results: </strong>We included 108 patients in the study (mean age 62.3 ± 11.7 years). Median NIHSS score was 12 (interquartile range 8-18). High baseline glucose levels, systolic blood pressure, baseline NIHSS, low Alberta Stroke Program Early CT Score, and hemorrhagic transformation were associated with poor outcomes. Elevated sST2 at 12 h (50.4 ± 51.0 ng/mL; p = 0.047) and 24 h (81.8 ± 101.3 ng/mL; p = 0.001) positively correlated with poor outcomes. MMP-9 (p = 0.086) and claudin-5 (p = 0.2) were not significantly associated with the outcome, although increased expressions of both markers were observed at 12 h. Multiple logistic regression showed that sST2 levels ≥71.8 ng/mL at 24 h, with a specificity of 96.9%, emerged as an independent predictor of poor functional outcome (OR: 6.44; 95% CI: 1.40-46.3; p = 0.029).</p><p><strong>Conclusion: </strong>Evaluation of sST2 may act as a reliable biomarker of functional outcome in AIS.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"33-40"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/55/cee-2023-0013-0001-529512.PMC10009551.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9165531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}