Effect of routine inflammatory markers on clinical outcomes in acute basilar artery occlusion after endovascular thrombectomy: Results from ATTENTION registry
Effect of routine inflammatory markers on clinical outcomes in acute basilar artery occlusion after endovascular thrombectomy: Results from ATTENTION registry
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DOI：
10.1177/17474930231176948
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发表时间：
2023-05
影响因子：
6.7
通讯作者：
Rui Li;Yamei Yin;Xueli Cai;Yu-you Zhu;Shuo Feng;Jun Sun;Chunrong Tao;Pengfei Xu;Li Wang;Jianlong Song;Qingqing Zhou;Wenhua Liu;Wei Hu
中科院分区：
文献类型：
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作者：
Rui Li;Yamei Yin;Xueli Cai;Yu-you Zhu;Shuo Feng;Jun Sun;Chunrong Tao;Pengfei Xu;Li Wang;Jianlong Song;Qingqing Zhou;Wenhua Liu;Wei Hu
背景资料：在接受血管内治疗（EVT）的急性基底动脉闭塞（BAO）患者中，研究临床常规炎症标志物（包括嗜中性粒细胞/淋巴细胞比率（NLR）、血小板/淋巴细胞比率（PLR）、平均血小板体积（MPV）、白色血细胞计数（WBC）、中性粒细胞、淋巴细胞和血小板）与临床结局之间的关系。方法：我们从2017年至2021年的ATTENTION登记研究中招募了来自中国22个省48个卒中中心的2134例急性BAO患者。入院时抽取血样。使用90天时4-6分的改良兰金量表（mRS）定义不利的功能结局。安全性结局包括90天内的死亡率和3天内的症状性脑出血。结果：最终研究共纳入1044例患者。校正混杂因素后，WBC和NLR的上四分位数与90天不良功能结局相关（mRS = 4-6）与最低四分位数的患者相比（WBC：四分位数4，比值比（OR）= 1.85，95%置信区间（CI）= 1.22-2.80; NLR：四分位数4，OR = 2.02，95% CI = 1.34-3.06）。WBC和NLR的较高四分位数也与90天时死亡风险增加相关。限制性三次样条回归分析显示NLR和90天不良功能结局之间有递增趋势（P非线性= 0.055）。在亚组分析中，NLR和桥接治疗之间存在显著的相互作用，可预测不良的功能结局（P = 0.006）。结论：在接受EVT的急性BAO患者中，入院时较高的WBC和NLR与不良功能结局和90天时的死亡率显著相关。在这些结局指标上，发现NLR增加和桥接治疗之间存在显著的相互作用。
Background: To investigate the relationship between clinical routine inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), white blood cell count (WBC), neutrophils, lymphocytes, and platelets with clinical outcomes in acute basilar artery occlusion (BAO) patients receiving endovascular treatment (EVT). Methods: We recruited 2134 acute BAO patients from 48 stroke centers across 22 Chinese provinces in the ATTENTION registry from 2017 to 2021. Blood samples were drawn at admission. An unfavorable functional outcome was defined using a modified Rankin Scale (mRS) of 4–6 at 90 days. Safety outcomes included mortality within 90 days and symptomatic intracerebral hemorrhage within 3 days. Results: A total of 1044 patients were included in the final study. After adjusting for confounding factors, the upper quartiles of WBC and NLR were related to 90-day unfavorable functional outcome (mRS = 4–6) compared with those in the lowest quartile (WBC: quartile 4, odds ratio (OR) = 1.85, 95% confidence interval (CI) = 1.22–2.80; NLR: quartile 4, OR = 2.02, 95% CI = 1.34–3.06). The higher quartiles of WBC and NLR were also related to the increased risk of mortality at 90 days. Restricted cubic spline regression analysis showed an incremental trend between NLR and 90-day unfavorable functional outcome (Pnonlinearity = 0.055). In subgroup analysis, a significant interaction was found between NLR and bridging therapy for predicting unfavorable functional outcome (P = 0.006). Conclusion: Higher WBC and NLR on admission are significantly related to unfavorable functional outcome and mortality at 90 days in acute BAO patients receiving EVT. Significant interaction was found between increased NLR and bridging therapy on these outcome measures.