Ischemic stroke and reperfusion therapies in diabetic patients

Currò, Carmelo Tiberio; Fiume, Giulia; Cotroneo, Masina; Russo, Giuseppina; Casella, Carmela; Dell’Aera, Cristina; Fazio, Maria; Grillo, Francesco; Laganà, Angelina; Trimarchi, Giuseppe; Toscano, Antonio; Vinci, Sergio Lucio; Musolino, Rosa Fortunata; Spina, Paolino La

doi:10.1007/s10072-022-05935-x

Cited by 6 publications

(5 citation statements)

References 38 publications

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“…Our finding of lower admission glycemia in the patients with good outcome after EVT (Table 1 ) might correspond to the results of a recent retrospective study, which showed that lower mRS was associated with lower admission glycemia in the diabetic patients treated with reperfusion therapy incl. mechanical thrombectomy [ 20 ]. Another recent study has shown, that a high glycemic variability in AIS patients contributed to poorer outcome after EVT [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, low levels of glycemia within the first 48 h after EVT may be associated with better three-month outcome [ 22 ]. Results from the recent studies showed the association between admission glycemia and functional outcome after MT in diabetic patients [ 25 ], and also in the patients with admission NIHSS ≥ 10 and MCA occlusion [ 26 ], specifically if they presented with clinical-ASPECT mismatch and achieved early recanalization (TICI 2b-3) [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Havlíček,

Šaňák,

Černík

et al. 2024

Cardiovasc Intervent Radiol

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Purpose Endovascular treatment (EVT) of tandem lesion (TL) in anterior circulation (AC) acute ischemic stroke (AIS) represents still a clinical challenge. We aimed to evaluate selected factors related to EVT and assess other possible predictors of good clinical outcome besides the generally known ones. Methods AIS patients with TL in AC treated with EVT were enrolled in the multicenter retrospective ASCENT study. A good three-month clinical outcome was scored as 0–2 points in modified Rankin Scale (mRS) and achieved recanalization using the TICI scale. Symptomatic intracerebral hemorrhage (SICH) was assessed using the SITS-MOST criteria. Logistic regression analysis was used for the assessment of possible predictors of mRS 0–2 with adjustment for potential confounders. Results In total, 300 (68.7% males, mean age 67.3 ± 10.2 years) patients with median of admission NIHSS 17 were analyzed. Recanalization (TICI 2b-3) was achieved in 290 (96.7%) patients and 176 (58.7%) had mRS 0–2. Besides the age, admission NIHSS and SICH, admission glycemia (p = 0.005, OR: 0.884) the stent patency within the first 30 days after EVT (p = 0.0003, OR: 0.219), dual antiplatelet therapy (DAPT) started within 12 h after EVT (p < 0.0001, OR: 5.006) and statin therapy started within 24 h after stenting (p < 0.0001, OR: 5.558) were found as other predictors. Conclusion Admission glycemia, start of DAPT within 12 h and statin therapy within 24 h after EVT, and stent patency within the first 30 days after EVT were found as other predictors of good three-month clinical outcome in AIS patients treated with EVT for TL. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Havlíček,

Šaňák,

Černík

et al. 2024

Cardiovasc Intervent Radiol

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“…Disease severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score and the Glasgow Coma Scale (GCS) score. 26 , 27 Plasma C3 levels were quantitatively measured with a Coulter reagent according to the manufacturer's instructions on the Beckman Coulter AU5800 clinical chemistry analyzer (Beckman Coulter Inc., California, USA). The test was performed and analyzed by the same technician.…”

Section: Methodsmentioning

confidence: 99%

Normobaric hyperoxia alleviates complement C3‐mediated synaptic pruning and brain injury after intracerebral hemorrhage

Wu,

Chen,

Zhao

et al. 2024

CNS Neurosci Ther

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BackgroundIntracerebral hemorrhage (ICH) is a common cerebrovascular disease, and the complement cascade exacerbates brain injury after ICH. As the most abundant component of the complement system, complement component 3 (C3) plays essential roles in all three complement pathways. However, the effects of C3 on neurological impairment and brain injury in ICH patients and the related mechanism have not been fully elucidated. Normobaric hyperoxia (NBO) is regarded as a treatment for ICH patients, and recent clinical studies also have confirmed the neuroprotective role of NBO against acute ICH‐mediated brain damage, but the underlying mechanism still remains elusive.AimsIn the present study, we investigated the effects of complement C3 on NBO‐treated ICH patients and model mice, and the underlying mechanism of NBO therapy in ICH‐mediated brain injury.ResultsHemorrhagic injury resulted in the high plasma C3 levels in ICH patients, and the plasma C3 levels were closely related to hemorrhagic severity and clinical outcomes after ICH. BO treatment alleviated neurologic impairments and rescued the hemorrhagic‐induced increase in plasma C3 levels in ICH patients and model mice. Moreover, the results indicated that NBO exerted its protective effects of on brain injury after ICH by downregulating the expression of C3 in microglia and alleviating microglia‐mediated synaptic pruning.ConclusionsOur results revealed that NBO exerts its neuroprotective effects by reducing C3‐mediated synaptic pruning, which suggested that NBO therapy could be used for the clinical treatment of ICH.

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“…The disease severity was assessed utilizing the National Institutes of Health Stroke Scale (NIHSS) score and the Glasgow Coma Scale (GCS) score by trained neurologists at admission ( Currò et al, 2022 ; Wan et al, 2022 ).…”

Section: Methodsmentioning

confidence: 99%

High plasma complement C4 levels as a novel predictor of clinical outcome in intracerebral hemorrhage

Chen

Jiang³

et al. 2023

Front. Aging Neurosci.

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ObjectiveThe complement cascade is activated and contributes to the brain injury after intracerebral hemorrhage (ICH). Complement component 4 (C4), an important component of complement cascade, has been associated with severity of neurological impairment that occurs during ICH. However, the correlation of plasma complement C4 levels with hemorrhagic severity and clinical outcome in ICH patients has not been reported.Materials and methodsThis study is a monocentric, real-world, cohort study. In this study, we measured the plasma complement C4 levels of 83 ICH patients and 78 healthy controls. The hematoma volume, the National Institutes of Health Stroke Scale (NIHSS) score, the Glasgow Coma Scale (GCS) score, and the permeability surface (PS) were used to assess and quantify neurological deficit following ICH. Logistic regression analysis was configured to determine the independent relation of plasma complement C4 levels to hemorrhagic severity and clinical outcomes. The contribution of complement C4 to secondary brain injury (SBI) was assessed by changes in plasma C4 levels between admission and at day 7 after ICH.ResultsThere was a significant elevation of plasma complement C4 levels in ICH patients than in healthy controls (40.48 ± 1.07 vs. 35.25 ± 0.60, p < 0.0001), and the plasma complement C4 levels were closely related to the hemorrhagic severity. Moreover, plasma complement C4 levels of patients were positively correlated with the hematoma volume (r = 0.501, p < 0.001), NIHSS score (r = 0.362, p < 0.001), the GCS score (r = −0.490, p < 0.001), and PS (r = 0.683, p = 0.045) following ICH. Logistic regression analysis also confirmed that patients with high plasma complement C4 levels show a poor clinical outcome after ICH (p < 0.001). Meanwhile, the elevated plasma levels at day 7 after ICH indicated the correlation of complement C4 with SBI (p < 0.01).ConclusionPlasma complement C4 levels are significantly elevated in ICH patients and positively correlated with the illness severity. Thus, these findings highlight the importance of complement C4 in brain injury after ICH and provide a novel predictor of clinical outcome for this disease.

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Ischemic stroke and reperfusion therapies in diabetic patients

Cited by 6 publications

References 38 publications

Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Normobaric hyperoxia alleviates complement C3‐mediated synaptic pruning and brain injury after intracerebral hemorrhage

High plasma complement C4 levels as a novel predictor of clinical outcome in intracerebral hemorrhage

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