Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.

Serum biomarkers are associated with hemorrhagic transformation and brain edema after cerebral infarction. However, whether serum biomarkers predict hemorrhagic transformation in large vessel occlusion stroke even after mechanical thrombectomy, which has become widely used, remains uncertain. In thi...

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Autores principales:	Takanori Iwamoto, Takaya Kitano, Naoki Oyama, Yoshiki Yagita
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5b7fac83a0ce4768bbae48e6c78b5380
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spelling	oai:doaj.org-article:5b7fac83a0ce4768bbae48e6c78b53802021-12-02T20:18:04ZPredicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.1932-620310.1371/journal.pone.0256170https://doaj.org/article/5b7fac83a0ce4768bbae48e6c78b53802021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256170https://doaj.org/toc/1932-6203Serum biomarkers are associated with hemorrhagic transformation and brain edema after cerebral infarction. However, whether serum biomarkers predict hemorrhagic transformation in large vessel occlusion stroke even after mechanical thrombectomy, which has become widely used, remains uncertain. In this prospective study, we enrolled patients with large vessel occlusion stroke in the anterior circulation. We analyzed 91 patients with serum samples obtained on admission. The levels of matrix metalloproteinase-9 (MMP-9), amyloid precursor protein (APP) 770, endothelin-1, S100B, and claudin-5 were measured. We examined the association between serum biomarkers and hemorrhagic transformation within one week. Fifty-four patients underwent mechanical thrombectomy, and 17 patients developed relevant hemorrhagic transformation (rHT, defined as hemorrhagic changes ≥ hemorrhagic infarction type 2). Neither MMP-9 (no rHT: 46 ± 48 vs. rHT: 15 ± 4 ng/mL, P = 0.30), APP770 (80 ± 31 vs. 85 ± 8 ng/mL, P = 0.53), endothelin-1 (7.0 ± 25.7 vs. 2.0 ± 2.1 pg/mL, P = 0.42), S100B (13 ± 42 vs. 12 ± 15 pg/mL, P = 0.97), nor claudin-5 (1.7 ± 2.3 vs. 1.9 ± 1.5 ng/mL, P = 0.68) levels on admission were associated with subsequent rHT. When limited to patients who underwent mechanical thrombectomy, the level of claudin-5 was higher in patients with rHT than in those without (1.2 ± 1.0 vs. 2.1 ± 1.7 ng/mL, P = 0.0181). APP770 levels were marginally higher in patients with a midline shift ≥ 5 mm than in those without (79 ± 29 vs. 97 ± 41 ng/mL, P = 0.084). The predictive role of serum biomarkers has to be reexamined in the mechanical thrombectomy era because some previously reported serum biomarkers may not predict hemorrhagic transformation, whereas the level of APP770 may be useful for predicting brain edema.Takanori IwamotoTakaya KitanoNaoki OyamaYoshiki YagitaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0256170 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Takanori Iwamoto Takaya Kitano Naoki Oyama Yoshiki Yagita Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.
description	Serum biomarkers are associated with hemorrhagic transformation and brain edema after cerebral infarction. However, whether serum biomarkers predict hemorrhagic transformation in large vessel occlusion stroke even after mechanical thrombectomy, which has become widely used, remains uncertain. In this prospective study, we enrolled patients with large vessel occlusion stroke in the anterior circulation. We analyzed 91 patients with serum samples obtained on admission. The levels of matrix metalloproteinase-9 (MMP-9), amyloid precursor protein (APP) 770, endothelin-1, S100B, and claudin-5 were measured. We examined the association between serum biomarkers and hemorrhagic transformation within one week. Fifty-four patients underwent mechanical thrombectomy, and 17 patients developed relevant hemorrhagic transformation (rHT, defined as hemorrhagic changes ≥ hemorrhagic infarction type 2). Neither MMP-9 (no rHT: 46 ± 48 vs. rHT: 15 ± 4 ng/mL, P = 0.30), APP770 (80 ± 31 vs. 85 ± 8 ng/mL, P = 0.53), endothelin-1 (7.0 ± 25.7 vs. 2.0 ± 2.1 pg/mL, P = 0.42), S100B (13 ± 42 vs. 12 ± 15 pg/mL, P = 0.97), nor claudin-5 (1.7 ± 2.3 vs. 1.9 ± 1.5 ng/mL, P = 0.68) levels on admission were associated with subsequent rHT. When limited to patients who underwent mechanical thrombectomy, the level of claudin-5 was higher in patients with rHT than in those without (1.2 ± 1.0 vs. 2.1 ± 1.7 ng/mL, P = 0.0181). APP770 levels were marginally higher in patients with a midline shift ≥ 5 mm than in those without (79 ± 29 vs. 97 ± 41 ng/mL, P = 0.084). The predictive role of serum biomarkers has to be reexamined in the mechanical thrombectomy era because some previously reported serum biomarkers may not predict hemorrhagic transformation, whereas the level of APP770 may be useful for predicting brain edema.
format	article
author	Takanori Iwamoto Takaya Kitano Naoki Oyama Yoshiki Yagita
author_facet	Takanori Iwamoto Takaya Kitano Naoki Oyama Yoshiki Yagita
author_sort	Takanori Iwamoto
title	Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.
title_short	Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.
title_full	Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.
title_fullStr	Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.
title_full_unstemmed	Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.
title_sort	predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/5b7fac83a0ce4768bbae48e6c78b5380
work_keys_str_mv	AT takanoriiwamoto predictinghemorrhagictransformationafterlargevesselocclusionstrokeintheeraofmechanicalthrombectomy AT takayakitano predictinghemorrhagictransformationafterlargevesselocclusionstrokeintheeraofmechanicalthrombectomy AT naokioyama predictinghemorrhagictransformationafterlargevesselocclusionstrokeintheeraofmechanicalthrombectomy AT yoshikiyagita predictinghemorrhagictransformationafterlargevesselocclusionstrokeintheeraofmechanicalthrombectomy
_version_	1718374344407646208

Predicting hemorrhagic transformation after large vessel occlusion stroke in the era of mechanical thrombectomy.

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