Stroke Department (L.M., L.D., E.O., T.-H.C., N.N.), Hospices Civils de Lyon, France.
INSERM U1060, CarMeN laboratory (L.M., T.B., A.P., C.C.D.S., E.O., M.O., T.-H.C.), University Lyon 1, France.
Stroke. 2020 Jul;51(7):2232-2235. doi: 10.1161/STROKEAHA.120.029395. Epub 2020 Jun 17.
In ischemic stroke, inflammatory status may condition the development of collateral circulation. Here we assessed the relationship between systemic inflammatory biomarkers and collateral status in large vessel occlusion before mechanical thrombectomy.
HIBISCUS-STROKE is a cohort study including acute ischemic stroke patients with large vessel occlusion treated with mechanical thrombectomy following admission magnetic resonance imaging. MMP-9 (matrix metalloproteinase-9) and MCP-1 (monocyte chemoattractant protein-1) were measured on blood sampling collected at admission. Collateral status was assessed on pretreatment Digital subtraction angiography and categorized into poor (Higashida score, 0-2) and good (Higashida score, 3-4). A multiple logistic regression model was performed to detect independent markers of good collateral status.
One hundred and twenty-two patients were included, of them 71 patients (58.2%) had a good collateral status. In univariate analysis, low MMP-9 levels (=0.01), high MCP-1 levels (<0.01), a low National Institute of Health Stroke Score (=0.046), a high diastolic blood pressure (=0.049), the absence of tandem occlusion (=0.046), a high Alberta Stroke Program Early CT Score (<0.01) and a low volume on the diffusion-weighted imaging (<0.01) were associated with good collateral status. Following multivariate analysis, low MMP-9 levels (=0.02) and high MCP-1 levels (<0.01) remained associated with good collateral status.
Low MMP-9 and high MCP-1 levels were associated with good pretreatment collateral status in patients with acute ischemic stroke with large vessel occlusion. These results might suggest a relationship between collateral status and inflammation.
在缺血性脑卒中患者中，炎症状态可能影响侧支循环的形成。本研究旨在评估机械取栓前大血管闭塞患者的全身炎症生物标志物与侧支循环状态之间的关系。
HIBISCUS-STROKE 是一项队列研究，纳入了接受机械取栓治疗的大血管闭塞性急性缺血性脑卒中患者。在入院时采集血样，检测基质金属蛋白酶-9（MMP-9）和单核细胞趋化蛋白-1（MCP-1）的水平。在治疗前的数字减影血管造影（DSA）上评估侧支循环状态，并分为较差（Higashida 评分 0-2）和较好（Higashida 评分 3-4）。采用多因素逻辑回归模型来检测良好侧支循环状态的独立标志物。
共纳入 122 例患者，其中 71 例（58.2%）的侧支循环状态较好。单因素分析显示，MMP-9 水平较低（=0.01）、MCP-1 水平较高（<0.01）、NIHSS 评分较低（=0.046）、舒张压较高（=0.049）、无串联闭塞（=0.046）、ASPECT 评分早期 CT 较高（<0.01）、弥散加权成像上的病灶体积较小（<0.01）与良好的侧支循环状态相关。多因素分析后，MMP-9 水平较低（=0.02）和 MCP-1 水平较高（<0.01）与良好的侧支循环状态仍相关。
在大血管闭塞性急性缺血性脑卒中患者中，MMP-9 水平较低和 MCP-1 水平较高与治疗前良好的侧支循环状态相关。这些结果可能提示侧支循环状态与炎症之间存在关联。
