Association of Blood Biomarkers of Inflammation With Penumbra Consumption After Mechanical Thrombectomy in Patients With Acute Ischemic Stroke

Abstract

Objectives:To assess the relationship between blood biomarkers of inflammation and lesion growth within the penumbra in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT).Methods:HIBISCUS-STROKE cohort enrolled patients admitted in the Lyon Stroke Center for an anterior circulation AIS treated with MT following MRI. Lesion growth within the penumbra was assessed on day-6 MRI using a voxel-based nonlinear coregistration method and dichotomized into low and high according to the median. C-reactive protein (CRP), interleukin (IL)-6, IL-8, IL-10, monocyte chemoattractant protein-1 (MCP-1), soluble tumor necrosis factor receptor I (sTNF-RI), soluble form suppression of tumorigenicity 2 (sST2), soluble P-selectin (sP-selectin), vascular cellular adhesion molecule-1 (VCAM-1) and matrix metalloproteinase-9 (MMP-9) were measured in sera at 4 timepoints within the first 48 hours. Reperfusion was considered as successful if Thrombolysis in Cerebral Infarction (TICI) score was 2b/2c/3. A multiple logistic regression model was performed to detect any association between area under the curve (AUC) of these biomarkers within the first 48 hours and a high lesion growth within the penumbra.Results:90 patients were included. Median lesion growth within the penumbra was 2.3 [0.7-6.2] mL. On multivariable analysis, a high sST2 AUC (odds ratio (OR) 3.77, 95% confidence interval (CI) 1.36-10.46) as well as a high baseline DWI volume (OR 3.65, 95% CI 1.32-10.12) and lack of successful reperfusion (OR 0.19, 95% CI 0.04-0.92) were associated with a high lesion growth within the penumbra. When restricting analyses to patients with successful reperfusion (n=76), a high sST2 AUC (OR 5.03, 95% CI 1.64-15.40), a high baseline DWI volume (OR 3.74, 95% CI 1.22-11.53) and a high penumbra volume (OR 3.25, 95% CI 1.10-9.57) remained associated with a high lesion growth within the penumbra.Conclusions: sST2 levels within the first 48 hours are associated with a high lesion growth within the penumbra.

Association Between Inflammatory Burden Index and Unfavorable Prognosis After Endovascular Thrombectomy in Acute Ischemic Stroke

“… 10 , 30 Third, CPR is a well-established inflammatory biomarker and is related to the ischemia-reperfusion injury, post-stroke infection, and inflammatory stimuli. 31 , 32 …”

Abnormal expression of miRNA-122 in cerebral infarction and related mechanism of regulating vascular endothelial cell proliferation and apoptosis by targeting CCNG1

“…In recent years, more studies have found that ACI can trigger the release of inflammatory factors and induce the occurrence of inflammatory responses. 19 , 20 Inflammatory reaction runs through the whole pathological process after the occurrence of ACI. 21 The higher risk of infection after ACI is associated with the suppression of immune function caused by cerebral infarction.…”

Specific inflammatory profile of acute ischemic stroke patients with left atrial enlargement

“…sST2 acts as a decoy receptor of IL-33 and therefore inhibits the M2 polarization effect of IL-33/ST2 signaling on microglial cells and macrophages ( 28 ). sST2 is associated with an expansion of the lesion within penumbra in AIS patients treated with MT and also with functional outcome and death ( 19 , 29 , 30 ). sST2 levels, which have proven their positive correlation with the left ventricular diameter and ejection fraction, and their diagnostic and prognostic value in heart failure, are also higher in patients with AF and are correlated with the left atrial diameter ( 15 , 31 ).…”