Absolute blood eosinophil count could be a potential biomarker for predicting haemorrhagic transformation after intravenous thrombolysis for acute ischaemic stroke

Autor: Paulius Mikužis, Renata Balnytė, Neringa Jucevičiūtė
Rok vydání: 2018
Předmět:
Male
Neurology
medicine.medical_treatment
Tissue plasminogen activator
lcsh:RC346-429
Brain Ischemia
Leukocyte Count
0302 clinical medicine
Thrombolytic Therapy
030212 general & internal medicine
Stroke
Aged
80 and over
Predictive marker
Immune cells
General Medicine
Thrombolysis
Middle Aged
drug therapy
Brain ischemia
Fibrinolytic agents
therapeutic use
administration&dosage
Administration
intravenous
adverse effects
Intracranial hemorrhages
chemically induced
Risk factors
Acute ischaemic stroke
Cardiology
Haemorrhagic transformation
Administration
Intravenous
Female
medicine.drug
Research Article
medicine.medical_specialty
education
Sensitivity and Specificity
03 medical and health sciences
Internal medicine
medicine
616.831-005.1 [udc]
Humans
lcsh:Neurology. Diseases of the nervous system
Aged
Cerebral Hemorrhage
Retrospective Studies
Receiver operating characteristic
business.industry
Retrospective cohort study
medicine.disease
Eosinophils
ROC Curve
Neurology (clinical)
business
Complication
030217 neurology & neurosurgery
Biomarkers
Zdroj: BMC Neurology
BMC Neurology, Vol 19, Iss 1, Pp 1-8 (2019)
BMC neurology, London : BioMed Central, 2019, vol. 19, no. 1, p. 1-8
ISSN: 1471-2377
Popis: Background Immune cells are involved in all stages of acute ischaemic stroke (AIS) and possess both neuroprotective and neurodamaging properties. It has been suggested that immune system activation after stroke may be associated with the development of haemorrhagic transformation (HT), which is the main complication limiting the clinical use of intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) for AIS. The purpose of our study was to analyse the association between absolute eosinophil count (AEC) at admission and the occurrence of HT after intravenous rtPA therapy for AIS. Methods In this retrospective study we enrolled AIS patients who were treated with rtPA within 4.5 h of symptom onset. Baseline stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS). Patients underwent head computed tomography scans at admission which were repeated 24 h after treatment with rtPA or promptly in case of clinical deterioration. HT was defined as blood at any site in the brain on follow-up head computed tomography scans. Spearman’s rank correlation test was used to analyse the correlation between AEC and NIHSS scores. The optimal AEC cut-off value for predicting HT was calculated using the area under the receiver operating characteristic curve. Multiple logistic regression was used to determine the association between AEC included as a binary variable and the incidence of HT. Results The data of 201 patients was analysed (59.7% females; median age 77 years); 23 (11.4%) of them developed HT. The median of AEC was 62.5% greater in the non-HT group compared to the HT group (0.13 × 109/l and 0.08 × 109/l, respectively, p = 0.026). No correlation was found between AEC and baseline NIHSS scores (r = 0.061, p = 0.393). AEC ≥ 0.11 × 109/l predicted the occurrence of HT with 69.6% sensitivity and 60.7% specificity. AEC ≥ 0.11 × 109/l was independently associated with a 78% reduction in the odds of developing HT (adjusted odds ratio = 0.223, 95% confidence interval = 0.069–0.723, p = 0.012). Conclusion Higher values of AEC were associated with lower odds of developing HT, thus, AEC at admission could be considered an independent predictive marker of HT after treatment with rtPA for AIS.
Databáze: OpenAIRE
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