Department of Neurology, The First School of Clinical Medicine, Jinling Hospital Southern Medical Universityt Jiangsu Province, 305 East Zhongshan Road, Xuanwu Distric, Nanjing, 210002, China.
Department of Neurology, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, 621000, China.
J Neurol. 2022 Feb;269(2):966-972. doi: 10.1007/s00415-021-10680-w. Epub 2021 Jul 5.
A previous study reported that cystatin C was related to acute ischemic stroke. The association between cystatin C and the clinical outcome in acute ischaemic stroke patients with successful recanalization after endovascular thrombectomy has rarely been reported. This study aimed to evaluate the association between cystatin C and futile recanalization in AIS patients who underwent endovascular thrombectomy.
We carried out a retrospective study of acute ischaemic stroke patients with anterior circulation proximal arterial occlusion who achieved complete arterial recanalization after mechanical thrombectomy from May 2017 to April 2020. The patients with complete recanalization were divided into a useful recanalization group and a futile recanalization group according to their 3-month modified Rankin scale score. FR was defined as a modified mRS score of 3-6 at 3 months. Logistic regression analysis was used to identify the risk factors for FR. Receiver operating characteristic curves were used to assess the predictive value of cystatin C for FR.
Of 241 patients, 125 underwent futile recanalization and 116 underwent useful recanalization. Baseline serum cystatin C levels were higher in the futile recanalization group than in the useful recanalization group. After adjustment for potential confounding factors, multivariable adjusted regression models showed that cystatin C was an independent predictor of futile recanalization (odds ratio, 4.111 [95% CI 1.427-11.840], P = 0.009). Receiver operator characteristic (ROC) curve analysis indicated that the model combining cystatin C with other factors model effectively predicted unfavourable outcomes at 3 months (area under the curve = 0.782, p < 0.01).
A higher level of cystatin C is associated with unfavourable outcomes at 3 months in anterior circulation acute ischaemic stroke patients with endovascular thrombectomy.
先前的研究表明胱抑素 C 与急性缺血性脑卒中有关。然而，血管内血栓切除术成功再通后，胱抑素 C 与急性缺血性脑卒中患者临床预后的相关性鲜有报道。本研究旨在评估血管内血栓切除术治疗的急性前循环近端动脉闭塞性缺血性脑卒中患者中胱抑素 C 与无效再通的相关性。
我们进行了一项回顾性研究，纳入了 2017 年 5 月至 2020 年 4 月期间接受机械取栓治疗后完全动脉再通的急性缺血性脑卒中患者。根据 3 个月时改良 Rankin 量表评分，将完全再通的患者分为有效再通组和无效再通组。FR 定义为 3 个月时改良 mRS 评分 3-6 分。采用 logistic 回归分析识别 FR 的危险因素。采用受试者工作特征曲线评估胱抑素 C 对 FR 的预测价值。
在 241 例患者中，125 例患者发生无效再通，116 例患者发生有效再通。无效再通组的基线血清胱抑素 C 水平高于有效再通组。在调整潜在混杂因素后，多变量调整回归模型显示胱抑素 C 是无效再通的独立预测因子（比值比，4.111[95%CI 1.427-11.840]，P=0.009）。受试者工作特征（ROC）曲线分析表明，联合胱抑素 C 与其他因素的模型能有效预测 3 个月时的不良结局（曲线下面积=0.782，P<0.01）。
在前循环急性缺血性脑卒中血管内血栓切除术治疗的患者中，较高水平的胱抑素 C 与 3 个月时的不良结局相关。
