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Cystatin C predicts futile recanalization in patients with acute ischemic stroke after endovascular treatment

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Abstract

Background

A previous study reported that cystatin C was related to acute ischemic stroke. The association between cystatin C and the clinical outcome in acute ischaemic stroke patients with successful recanalization after endovascular thrombectomy has rarely been reported. This study aimed to evaluate the association between cystatin C and futile recanalization in AIS patients who underwent endovascular thrombectomy.

Methods

We carried out a retrospective study of acute ischaemic stroke patients with anterior circulation proximal arterial occlusion who achieved complete arterial recanalization after mechanical thrombectomy from May 2017 to April 2020. The patients with complete recanalization were divided into a useful recanalization group and a futile recanalization group according to their 3-month modified Rankin scale score. FR was defined as a modified mRS score of 3–6 at 3 months. Logistic regression analysis was used to identify the risk factors for FR. Receiver operating characteristic curves were used to assess the predictive value of cystatin C for FR.

Results

Of 241 patients, 125 underwent futile recanalization and 116 underwent useful recanalization. Baseline serum cystatin C levels were higher in the futile recanalization group than in the useful recanalization group. After adjustment for potential confounding factors, multivariable adjusted regression models showed that cystatin C was an independent predictor of futile recanalization (odds ratio, 4.111 [95% CI 1.427–11.840], P = 0.009). Receiver operator characteristic (ROC) curve analysis indicated that the model combining cystatin C with other factors model effectively predicted unfavourable outcomes at 3 months (area under the curve = 0.782, p < 0.01).

Conclusions

A higher level of cystatin C is associated with unfavourable outcomes at 3 months in anterior circulation acute ischaemic stroke patients with endovascular thrombectomy.

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Authors and Affiliations

  1. Department of Neurology, The First School of Clinical Medicine, Jinling Hospital Southern Medical Universityt Jiangsu Province, 305 East Zhongshan Road, Xuanwu Distric, Nanjing, 210002, China

    Mouxiao Su & Gelin Xu

  2. Department of Neurology, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, 621000, China

    Mouxiao Su, Zhonglun Chen, Mingjun Pu, Zhaokun Li & Hongcai Du

  3. Department of Radiology, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, Sichuan, China

    Ying Zhou

  4. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China

    Gelin Xu

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Correspondence to Gelin Xu.

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Su, M., Zhou, Y., Chen, Z. et al. Cystatin C predicts futile recanalization in patients with acute ischemic stroke after endovascular treatment. J Neurol 269, 966–972 (2022). https://doi.org/10.1007/s00415-021-10680-w

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  • DOI: https://doi.org/10.1007/s00415-021-10680-w

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