Acute Ischemic Stroke
Conditions
Keywords
Thrombectomy, soluble TREM-1, soluble TREM-2
Brief summary
Soluble triggering receptor expressed on myeloid cells (sTREM), which reflects microglia activation, has been reported closely associated with neuronal injury and neuroinflammation. This study is to investigatethe prognostic roles of sTREM (sTREM1 and sTREM2) in patients with ischemic stroke who underwent endovascular thrombectomy (EVT).
Detailed description
For acute ischemic stroke, the current treatment strategy involves timely recanalization by intravenous thrombolysis and endovascular thrombectomy (EVT). Patients receiving EVT are more likely to achieve successful revascularization and long--term functional independence compared with those receiving standard medical treatment.1 In patients receiving EVT, significant predictors of a favorable functional outcome include minor initial stroke severity, successful recanalization, and shorter onset--to--treatment time. However, unfavorable outcomes can occur even after early successful recanalization in some cases.Triggering receptors expressed on myeloid cells (TREM-1 and TREM-2) are a familyof receptors involved in the immune system expressed on a variety of innate cells of the myeloid lineage, including microglia. sTREM, which reflects microglia activation, has been reported closely associated with neuronal injury and neuroinflammation. We enrolled adult patients with stroke who received EVT, with blood sampling immediately before (T1) and after EVT (T2), and at 24 hours after EVT (T3). Non--stroke controls and patients with non--EVT stroke were also enrolled. The plasma concentration of sTREM1 and sTREM2 were analyzed by ELISA. The medical information, image findings and levels of plasma sTREM1 and sTREM2 were analyzed to clarify the association with poor functional outcome (modified Rankin Scale 4-6) at 3 months after stroke.
Interventions
None listed
Sponsors
The Affiliated Hospital of Xuzhou Medical University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Patients \> 18 years old. * Patients with acute large vessel occlusion within 24 hours of onset who will receive endovascular treatment.
Exclusion criteria
* Impossibility of getting a blood sample. * Impossibility of performing the test (Invalid results). * Refusal to provide the informed consent by the patient/relative.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic changes in plasma levels of sTREM-1 and sTREM-2 following Endovascular Therapy | From baseline to immediately, 24 hours, 3 days, and 7 days after Endovascular Therapy | Plasma levels of sTREM-1 and sTREM-2 will be quantified using the ELISA method. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| favourable functional outcome, defined as modified Rankin Scale (mRS) 0-2 | 90 days | mRS ranges from 0-6, high score means poor outcome |
| excellent functional outcome, defined as modified Rankin Scale (mRS) 0-1 | 30 days | mRS ranges from 0-6, high score means poor outcome |
| early neurological improvement, defined as 4 or more decrease in National Institute of Health stroke scale (NIHSS) | 24 hours | NIHSS ranges from 0-22, with high score meaning severe neurological deficit. |
| Hemorrhagic transformation | 72 hours | Hemorrhagic transformation was diagnosed by Computed tomographic scans usually performed 24 to 72 hours after the procedure.Symptomatic intracranial hemorrhage was defined as neurologic deterioration (an increase of 4 or more points in the score on the NIHSS) and evidence of intracranial hemorrhage on imaging studies. |
Countries
China
Contacts
Primary ContactXingzhi Wang, MD
Outcome results
None listed