William Boisseau1, Jean-Philippe Desilles2, Robert Fahed1, Maeva Kyheng1, Kevin Zuber1, Candice Sabben1, Guillaume Taylor1, Malek Ben Maacha1, Benjamin Maier1, Daniele Botta1, Simon Escalard1, Gabriele Ciccio1, Stanislas Smajda1, Hocine Redjem1, Michel Piotin1, Mikael Mazighi1, Raphael Blanc1. 1. From the Departments of Interventional Neuroradiology (W.B., J.-P.D., R.F., B.M., D.B., S.E., G.C., S.S., H.R., M.P., M.M., R.B.), Clinical Research (K.Z., M.B.M.), Neurology (C.S.), and Intensive Care (G.T.), Rothschild Foundation Hospital; Université Paris Diderot (J.-P.D., M.M.), Sorbonne Paris Cite; Laboratory of Vascular Translational Science (J.-P.D., M.P., M.M., R.B.), U1148 Institut National de la Santé et de la Recherche Médicale (INSERM), Paris; and Department of Clinical Research (M.K.), CHRU Lille, Lille, France. 2. From the Departments of Interventional Neuroradiology (W.B., J.-P.D., R.F., B.M., D.B., S.E., G.C., S.S., H.R., M.P., M.M., R.B.), Clinical Research (K.Z., M.B.M.), Neurology (C.S.), and Intensive Care (G.T.), Rothschild Foundation Hospital; Université Paris Diderot (J.-P.D., M.M.), Sorbonne Paris Cite; Laboratory of Vascular Translational Science (J.-P.D., M.P., M.M., R.B.), U1148 Institut National de la Santé et de la Recherche Médicale (INSERM), Paris; and Department of Clinical Research (M.K.), CHRU Lille, Lille, France. jpdesilles@gmail.com.
Abstract
OBJECTIVE: To identify early prognostic factors of poor clinical outcome in patients treated by endovascular therapy (EVT) with successful recanalization. METHODS: We reviewed our monocentric prospectively collected EVT database of patients with anterior circulation acute ischemic stroke (AIS) from January 2016 to April 2018 who had achieved successful recanalization (Thrombolysis in Cerebral Infarction score ≥ 2b) at the end of the procedure. A poor outcome was defined as a 3-month modified Rankin Scale score of ≥3. RESULTS: A total of 324 patients were included, among whom 186 (57.4%) had a poor outcome. Multivariate logistic regression indicated that age (per 10-year increase, odds ratio [OR] 1.34, 95% confidence interval [CI] 1.12-1.60), baseline NIH Stroke Scale score (per 1-unit increase, OR 1.09, 95% CI 1.04-1.15), initial infarct volume (per a log+1 increase, OR 1.34, 95% CI 1.05-1.67), blood glucose level (per a log+1 increase, OR 2.60, 95% CI 1.01-6.66), and neutrophil count (per 1,000-unit increase, OR 1.08, 95% CI 1.01-1.17) were all associated with poor clinical outcome. CONCLUSIONS: In addition to baseline severe AIS criteria, high neutrophil count and high blood glucose, known from experimental studies to be associated with downstream microvascular thromboinflammation, are independently associated with poor outcome. These findings support a deleterious role of thromboinflammation in patient recovery despite successful recanalization.
OBJECTIVE: To identify early prognostic factors of poor clinical outcome in patients treated by endovascular therapy (EVT) with successful recanalization. METHODS: We reviewed our monocentric prospectively collected EVT database of patients with anterior circulation acute ischemic stroke (AIS) from January 2016 to April 2018 who had achieved successful recanalization (Thrombolysis in Cerebral Infarction score ≥ 2b) at the end of the procedure. A poor outcome was defined as a 3-month modified Rankin Scale score of ≥3. RESULTS: A total of 324 patients were included, among whom 186 (57.4%) had a poor outcome. Multivariate logistic regression indicated that age (per 10-year increase, odds ratio [OR] 1.34, 95% confidence interval [CI] 1.12-1.60), baseline NIH Stroke Scale score (per 1-unit increase, OR 1.09, 95% CI 1.04-1.15), initial infarct volume (per a log+1 increase, OR 1.34, 95% CI 1.05-1.67), blood glucose level (per a log+1 increase, OR 2.60, 95% CI 1.01-6.66), and neutrophil count (per 1,000-unit increase, OR 1.08, 95% CI 1.01-1.17) were all associated with poor clinical outcome. CONCLUSIONS: In addition to baseline severe AIS criteria, high neutrophil count and high blood glucose, known from experimental studies to be associated with downstream microvascular thromboinflammation, are independently associated with poor outcome. These findings support a deleterious role of thromboinflammation in patient recovery despite successful recanalization.
Authors: Senna Staessens; Olivier François; Waleed Brinjikji; Karen M Doyle; Peter Vanacker; Tommy Andersson; Simon F De Meyer Journal: Stroke Date: 2021-09-14 Impact factor: 7.914
Authors: Frederik Denorme; Bhanu Kanth Manne; Irina Portier; Alicia S Eustes; Yasuhiro Kosaka; Benjamin T Kile; Matthew T Rondina; Robert A Campbell Journal: Blood Date: 2020-02-06 Impact factor: 25.476