Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy
Background and purposeData on adhesion molecule levels in patients treated with mechanical thrombectomy (MT) are scarce. We aimed to evaluate the association among adhesion molecule levels, symptomatic intracranial hemorrhage (sICH), and clinical outcome and to determine whether the sICH influences...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1024162/full |
| _version_ | 1811208355554787328 |
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| author | Xiaohao Zhang Xiaohao Zhang Feng Zhou Wei Wang Yan E Shuaiyu Chen Haiming Cao Huiwen Lian Teng Jiang Yingdong Zhang Hongchao Shi Junshan Zhou |
| author_facet | Xiaohao Zhang Xiaohao Zhang Feng Zhou Wei Wang Yan E Shuaiyu Chen Haiming Cao Huiwen Lian Teng Jiang Yingdong Zhang Hongchao Shi Junshan Zhou |
| author_sort | Xiaohao Zhang |
| collection | DOAJ |
| description | Background and purposeData on adhesion molecule levels in patients treated with mechanical thrombectomy (MT) are scarce. We aimed to evaluate the association among adhesion molecule levels, symptomatic intracranial hemorrhage (sICH), and clinical outcome and to determine whether the sICH influences the association of adhesion molecules with functional outcome.MethodsPatients with large artery occlusion in the anterior circulation and treated with MT were prospectively recruited. Adhesion molecules, such as soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble E-selectin (sE-selectin) were tested. An unfavorable outcome was defined as a 90-day modified Rankin Scale (mRS) score of 3–6. The sICH was diagnosed according to the Heidelberg Bleeding Classification within 72 h of endovascular treatment (EVT).ResultsOf the 310 enrolled patients (mean age, 68.5 years; 198 men), 46 (14.8%) experienced sICH and 173 (55.8%) experienced an unfavorable outcome at 90 days. After adjusting for potential confounders, patients with higher sVCAM-1 and sE-selectin levels had an increasing trend of sICH [4th quartile vs. 1st quartile for sVCAM-1; odds ratio (OR), 2.766, p = 0.085; sE-selectin; OR, 2.422, p = 0.086] and poor outcome (4th quartile vs. 1st quartile for sVCAM-1; OR, 2.614, p = 0.025; sE-selectin; OR, 2.325, p = 0.046). Furthermore, the sICH might partially mediate the worse functional outcome in patients with higher adhesion molecules levels (Sobel test, p < 0.001 for sVCAM-1 and p = 0.007 for sE-selectin).ConclusionsThere were significant relationships between levels of adhesion molecules and a 90-day poor outcome in patients with ischemic stroke treated with MT, which was partially mediated by sICH. |
| first_indexed | 2024-04-12T04:19:46Z |
| format | Article |
| id | doaj.art-3cef26951cdb492f96152ee4b8d4fe73 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T04:19:46Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-3cef26951cdb492f96152ee4b8d4fe732022-12-22T03:48:15ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-09-011310.3389/fneur.2022.10241621024162Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomyXiaohao Zhang0Xiaohao Zhang1Feng Zhou2Wei Wang3Yan E4Shuaiyu Chen5Haiming Cao6Huiwen Lian7Teng Jiang8Yingdong Zhang9Hongchao Shi10Junshan Zhou11Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaBackground and purposeData on adhesion molecule levels in patients treated with mechanical thrombectomy (MT) are scarce. We aimed to evaluate the association among adhesion molecule levels, symptomatic intracranial hemorrhage (sICH), and clinical outcome and to determine whether the sICH influences the association of adhesion molecules with functional outcome.MethodsPatients with large artery occlusion in the anterior circulation and treated with MT were prospectively recruited. Adhesion molecules, such as soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble E-selectin (sE-selectin) were tested. An unfavorable outcome was defined as a 90-day modified Rankin Scale (mRS) score of 3–6. The sICH was diagnosed according to the Heidelberg Bleeding Classification within 72 h of endovascular treatment (EVT).ResultsOf the 310 enrolled patients (mean age, 68.5 years; 198 men), 46 (14.8%) experienced sICH and 173 (55.8%) experienced an unfavorable outcome at 90 days. After adjusting for potential confounders, patients with higher sVCAM-1 and sE-selectin levels had an increasing trend of sICH [4th quartile vs. 1st quartile for sVCAM-1; odds ratio (OR), 2.766, p = 0.085; sE-selectin; OR, 2.422, p = 0.086] and poor outcome (4th quartile vs. 1st quartile for sVCAM-1; OR, 2.614, p = 0.025; sE-selectin; OR, 2.325, p = 0.046). Furthermore, the sICH might partially mediate the worse functional outcome in patients with higher adhesion molecules levels (Sobel test, p < 0.001 for sVCAM-1 and p = 0.007 for sE-selectin).ConclusionsThere were significant relationships between levels of adhesion molecules and a 90-day poor outcome in patients with ischemic stroke treated with MT, which was partially mediated by sICH.https://www.frontiersin.org/articles/10.3389/fneur.2022.1024162/fulladhesion moleculesischemic strokethrombectomymediation analysisvascular cell adhesion molecule-1 |
| spellingShingle | Xiaohao Zhang Xiaohao Zhang Feng Zhou Wei Wang Yan E Shuaiyu Chen Haiming Cao Huiwen Lian Teng Jiang Yingdong Zhang Hongchao Shi Junshan Zhou Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy Frontiers in Neurology adhesion molecules ischemic stroke thrombectomy mediation analysis vascular cell adhesion molecule-1 |
| title | Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy |
| title_full | Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy |
| title_fullStr | Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy |
| title_full_unstemmed | Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy |
| title_short | Levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy |
| title_sort | levels of adhesion molecules and clinical outcomes in patients with ischemic stroke after mechanical thrombectomy |
| topic | adhesion molecules ischemic stroke thrombectomy mediation analysis vascular cell adhesion molecule-1 |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1024162/full |
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