The role of neutrophil and LDL-C levels in predicting intracranial hemorrhage following endovascular thrombectomy in patients with acute ischemic stroke

被引:0
作者
Chen, Li [1 ,2 ]
Cui, Lei [3 ]
Ji, Yi-Fei [2 ]
Li, Xin [1 ]
机构
[1] Tianjin Med Univ, Hosp 2, Dept Neurol, Tianjin, Peoples R China
[2] North Sichuan Med Univ, Nanchong Cent Hosp, Dept Neurol, Clin Med Coll 2, Sichuan, Peoples R China
[3] Tianjin Third Cent Hosp, Dept Neurol, Tianjin, Peoples R China
基金
中国国家自然科学基金;
关键词
Acute ischemic stroke; Intracranial hemorrhage; Endovascular thrombectomy; Preoperative neutrophil and LDL-C levels; THROMBOLYSIS;
D O I
10.1016/j.jstrokecerebrovasdis.2024.107925
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Objectives: To investigate the association between intracranial hemorrhage (ICH) and preoperative levels of neutrophils and low-density lipoprotein-cholesterol (LDL-C) in acute ischemic stroke (AIS) patients following endovascular thrombectomy (EVT), and to assess the predictive value of preoperative levels of neutrophils and LDL-C. Methods: A retrospective analysis was performed on the clinical records of patients diagnosed with AIS who underwent EVT at Nanchong Central Hospital between 2019 and 2023. Multivariate regression analysis was employed to examine the association of preoperative levels of neutrophils and LDL-C with the occurrence of ICH. Furthermore, a receiver operating characteristic curve was constructed to assess the predictive efficacy of these parameters. Results: A total of 300 patients with a mean age of 68.0 years (standard deviation, 11.1 years) and a median baseline National Institutes of Health Stroke scale (NIHSS) score of 15.5 (interquartile range, 12.0-19.75) were identified in this cohort. Of these, 28 (9.3%) patients experienced ICH. Multivariate regression analysis revealed that elevated preoperative neutrophil (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.38, P <0.001) and LDL-C (OR 2.64, 95% CI 1.52-4.58, P < 0.001) levels were independently associated with ICH. The combined indicator demonstrated a higher area under the curve (AUC 0.759, 95% CI 0.654-0.865) compared with preoperative neutrophil (AUC 0.647, 95% CI 0.532-0.763) and LDL-C (AUC 0.711, 95% CI 0.607-0.814) levels individually.The specificity and sensitivity of the combined indicator were 67.9% and 83.1%, respectively. Conclusions: Preoperative levels of neutrophils and LDL-C may serve as predictive indicators for ICH in patients with AIS who have undergone EVT; moreover, the combination of preoperative neutrophil and LDL-C levels demonstrates enhanced predictive efficacy.
引用
收藏
页数:4
相关论文
共 25 条
[1]   Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging [J].
Albers, G. W. ;
Marks, M. P. ;
Kemp, S. ;
Christensen, S. ;
Tsai, J. P. ;
Ortega-Gutierrez, S. ;
McTaggart, R. A. ;
Torbey, M. T. ;
Kim-Tenser, M. ;
Leslie-Mazwi, T. ;
Sarraj, A. ;
Kasner, S. E. ;
Ansari, S. A. ;
Yeatts, S. D. ;
Hamilton, S. ;
Mlynash, M. ;
Heit, J. J. ;
Zaharchuk, G. ;
Kim, S. ;
Carrozzella, J. ;
Palesch, Y. Y. ;
Demchuk, A. M. ;
Bammer, R. ;
Lavori, P. W. ;
Broderick, J. P. ;
Lansberg, M. G. .
NEW ENGLAND JOURNAL OF MEDICINE, 2018, 378 (08) :708-718
[2]   A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke [J].
Amarenco, P. ;
Kim, J. S. ;
Labreuche, J. ;
Charles, H. ;
Abtan, J. ;
Bejot, Y. ;
Cabrejo, L. ;
Cha, J-K ;
Ducrocq, G. ;
Giroud, M. ;
Guidoux, C. ;
Hobeanu, C. ;
Kim, Y. J. ;
Lapergue, B. ;
Lavallee, P. C. ;
Lee, B-C ;
Lee, K-B ;
Leys, D. ;
Mahagne, M-H ;
Meseguer, E. ;
Nighoghossian, N. ;
Pico, F. ;
Samson, Y. ;
Sibon, I ;
Steg, P. G. ;
Sung, S-M ;
Touboul, P. J. ;
Touze, E. ;
Varenne, O. ;
Vicaut, E. ;
Yelles, N. ;
Bruckert, E. .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (01) :9-19
[3]   Benefit of Targeting a LDL (Low-Density Lipoprotein) Cholesterol <70 mg/dL During 5 Years After Ischemic Stroke [J].
Amarenco, Pierre ;
Kim, Jong S. ;
Labreuche, Julien ;
Charles, Hugo ;
Giroud, Maurice ;
Lee, Byung-Chul ;
Mahagne, Marie-Helene ;
Nighoghossian, Norbert ;
Steg, Philippe Gabriel ;
Vicaut, Eric ;
Bruckert, Eric .
STROKE, 2020, 51 (04) :1231-1239
[4]   Effect of intravenous thrombolysis before endovascular therapy on outcomes in patients with large core infarct [J].
Anadani, Mohammad ;
Almallouhi, Eyad ;
Maier, Ilko ;
Al Kasab, Sami ;
Jabbour, Pascal ;
Kim, Joon-tae ;
Wolfe, Stacey Q. ;
Rai, Ansaar ;
Starke, Robert M. ;
Psychogios, Marios-Nikos ;
Samaniego, Edgar A. ;
Arthur, Adam S. ;
Yoshimura, Shinichi ;
Cuellar, Hugo ;
Howard, Brian M. ;
Alawieh, Ali ;
Fragata, Isabel ;
Polifka, Adam J. ;
Mascitelli, Justin R. ;
Osbun, Joshua W. ;
Matouk, Charles ;
Park, Min S. ;
Levitt, Michael R. ;
Dumont, Travis M. ;
Williamson, Richard ;
Spiotta, Alejandro M. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2023, 15 (E3) :e414-e418
[5]   Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial [J].
Bracard, Serge ;
Ducrocq, Xavier ;
Mas, Jean Louis ;
Soudant, Marc ;
Oppenheim, Catherine ;
Moulin, Thieriy ;
Guillemin, Francis .
LANCET NEUROLOGY, 2016, 15 (11) :1138-1147
[6]  
Chilton Robert J, 2004, J Am Osteopath Assoc, V104, pS5
[7]   Reperfusion Changes After Stroke and Practical Approaches for Neuroprotection [J].
Choi, Jae H. ;
Pile-Spellman, John .
NEUROIMAGING CLINICS OF NORTH AMERICA, 2018, 28 (04) :663-682
[8]   Thrombus Neutrophil Extracellular Traps Content Impair tPA-Induced Thrombolysis in Acute Ischemic Stroke [J].
Ducroux, Celina ;
Di Meglio, Lucas ;
Loyau, Stephane ;
Delbosc, Sandrine ;
Boisseau, William ;
Deschildre, Catherine ;
Ben Maacha, Malek ;
Blanc, Raphael ;
Redjem, Hocine ;
Ciccio, Gabriele ;
Smajda, Stanislas ;
Fahed, Robert ;
Michel, Jean-Baptiste ;
Piotin, Michel ;
Salomon, Laurence ;
Mazighi, Mikael ;
Ho-Tin-Noe, Benoit ;
Desilles, Jean-Philippe .
STROKE, 2018, 49 (03) :754-757
[9]   Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke [J].
Goyal, M. ;
Demchuk, A. M. ;
Menon, B. K. ;
Eesa, M. ;
Rempel, J. L. ;
Thornton, J. ;
Roy, D. ;
Jovin, T. G. ;
Willinsky, R. A. ;
Sapkota, B. L. ;
Dowlatshahi, D. ;
Frei, D. F. ;
Kamal, N. R. ;
Montanera, W. J. ;
Poppe, A. Y. ;
Ryckborst, K. J. ;
Silver, F. L. ;
Shuaib, A. ;
Tampieri, D. ;
Williams, D. ;
Bang, O. Y. ;
Baxter, B. W. ;
Burns, P. A. ;
Choe, H. ;
Heo, J. -H. ;
Holmstedt, C. A. ;
Jankowitz, B. ;
Kelly, M. ;
Linares, G. ;
Mandzia, J. L. ;
Shankar, J. ;
Sohn, S. -I. ;
Swartz, R. H. ;
Barber, P. A. ;
Coutts, S. B. ;
Smith, E. E. ;
Morrish, W. F. ;
Weill, A. ;
Subramaniam, S. ;
Mitha, A. P. ;
Wong, J. H. ;
Lowerison, M. W. ;
Sajobi, T. T. ;
Hill, M. D. .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1019-1030
[10]   Incidence of intracranial hemorrhagic complications after anterior circulation endovascular thrombectomy in relation to occlusion site: a nationwide observational register study [J].
Hall, Emma ;
Ullberg, Teresa ;
Andsberg, Gunnar ;
Wasselius, Johan .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2024, 16 (11) :1088-+