Can Yusuf, Kocayigit Ibrahim
Department of Cardiology, University of Sakarya, Sakarya, Turkey.
Arch Med Sci Atheroscler Dis. 2020 Jul 27;5:e206-e211. doi: 10.5114/amsad.2020.97722. eCollection 2020.
The vasospasm of carotid arteries is important for the progression of neurological sequelae. Many mechanisms have been found to be related to this clinical phenomenon. Predicting this event by using hematological biomarkers may provide opportunities for adopting preventive measures against unfavorable neurovascular complications. The aim of this study is to determine the hematological predictors of carotid artery vasospasm during carotid stenting.
A total of 120 patients who underwent carotid stenting were divided into two groups: those with and without carotid artery vasospasm. Carotid artery vasospasm was angiographically defined as transient or persistent emergent stenosis or irregularity of the vessel wall without evidence of thrombosis during carotid stenting. The hematological parameters were compared between 21 patients who developed carotid artery vasospasm (17.5%) and 99 patients who did not (82.5%).
The mean age of the patients with carotid artery vasospasm and without carotid artery vasospasm was 66 ±8 and 70 ±8 years, respectively. Creatinine levels within 0.5-0.9 (OR = 3.704, 95% CI: 1.245-11.019, = 0.019), each 1000 unit increase in neutrophil count (OR = 1.567, 95% CI: 1.027-2.392, = 0.037) and presence of diabetes (OR = 3.081, 95% CI: 1.116-8.505, = 0.030) were the independent predictors of carotid artery vasospasm in carotid arteries during carotid stenting.
The prediction of carotid artery vasospasm during carotid stenting should help clinicians adopt preventive measures against the development of neurological sequelae. This study found that creatinine levels, increased neutrophil count and presence of diabetes are independent predictors of carotid artery vasospasm.
颈动脉血管痉挛对神经后遗症的进展至关重要。已发现许多机制与这一临床现象相关。通过血液生物标志物预测这一事件可能为采取预防不利神经血管并发症的措施提供机会。本研究的目的是确定颈动脉支架置入术中颈动脉血管痉挛的血液学预测指标。
总共120例行颈动脉支架置入术的患者被分为两组：发生颈动脉血管痉挛的患者和未发生颈动脉血管痉挛的患者。颈动脉血管痉挛在血管造影上被定义为颈动脉支架置入术中血管壁出现短暂或持续性进行性狭窄或不规则，且无血栓形成证据。比较了21例发生颈动脉血管痉挛（17.5%）和99例未发生颈动脉血管痉挛（82.5%）患者的血液学参数。
发生颈动脉血管痉挛和未发生颈动脉血管痉挛患者的平均年龄分别为66±8岁和70±8岁。肌酐水平在0.5 - 0.9之间（比值比 = 3.704，95%可信区间：1.245 - 11.019，P = 0.019）、中性粒细胞计数每增加1000个单位（比值比 = 1.567，95%可信区间：1.027 - 2.392，P = 0.037）以及患有糖尿病（比值比 = 3.081，95%可信区间：1.116 - 8.505，P = 0.030）是颈动脉支架置入术中颈动脉血管痉挛的独立预测指标。
颈动脉支架置入术中颈动脉血管痉挛的预测应有助于临床医生采取预防神经后遗症发生的措施。本研究发现肌酐水平、中性粒细胞计数增加和患有糖尿病是颈动脉血管痉挛的独立预测指标。
