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Thromb Haemost 2018; 118(04): 758-767
DOI: 10.1055/s-0038-1637732
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH Stuttgart

ADAMTS-13 Activity Predicts Outcome in Acute Ischaemic Stroke Patients Undergoing Endovascular Treatment

Ramona Schuppner
1   Department of Neurology, Hannover Medical School, Hannover, Germany
,
Meike Dirks
1   Department of Neurology, Hannover Medical School, Hannover, Germany
,
Gerrit M. Grosse
1   Department of Neurology, Hannover Medical School, Hannover, Germany
,
Matthias Böckmann
1   Department of Neurology, Hannover Medical School, Hannover, Germany
,
Friedrich Goetz
2   Department of Neuroradiology, Hannover Medical School, Hannover, Germany
,
Thomas Pasedag
1   Department of Neurology, Hannover Medical School, Hannover, Germany
3   Department of Psychiatry, Kliniken der Region Hannover, Langenhagen, Germany
,
Stefanie M. Bode-Böger
4   Department of Clinical Pharmacology, Otto-von-Guericke University, Magdeburg, Germany
,
Jens Martens-Lobenhoffer
4   Department of Clinical Pharmacology, Otto-von-Guericke University, Magdeburg, Germany
,
Ulrich Budde
5   Medilys Laboratory, Asklepios Clinic Altona, Hamburg, Germany
,
Heinrich Lanfermann
2   Department of Neuroradiology, Hannover Medical School, Hannover, Germany
,
Ralf Lichtinghagen
6   Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
,
Karin Weissenborn   *
1   Department of Neurology, Hannover Medical School, Hannover, Germany
,
Hans Worthmann   *
1   Department of Neurology, Hannover Medical School, Hannover, Germany
› Author Affiliations
Further Information

Publication History

06 October 2017

26 January 2018

Publication Date:
04 April 2018 (online)

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Abstract

Background Endovascular treatment improves outcome in patients with acute ischaemic stroke due to large vessel occlusion in general. But outcome in some of these patients is jeopardized by recanalization failure or bleeding.

Objectives This study aimed to determine a possible association of mediators of inflammation and haemostasis (C-reactive protein, interleukin-6, matrix metalloproteinase-9, monocyte chemoattractant protein-1, asymmetric dimethylarginine [ADMA], symmetric dimethylarginine, von Willebrand factor and a disintegrin and metalloproteinase with a thrombospondin type 1 motif 13 [ADAMTS-13]) with the post-intervention grade of reperfusion, complications and clinical outcome in patients who underwent endovascular treatment of ischaemic stroke.

Patients/Methods Forty-one patients with acute ischaemic stroke due to large vessel occlusion were prospectively enrolled into the study. Peripheral venous blood was taken prior to treatment and 24 hours and 3, 7 and 90 days after symptom onset. The post-intervention grade of reperfusion was determined using the modified Treatment in Cerebral Infarction (mTICI) score. Clinical outcome on day 90 was assessed using the modified Rankin's scale (mRS).

Results Low ADAMTS-13 activity (p = 0.009) and missing of statin therapy (p = 0.038) on admission were independently associated with unfavourable outcome (mRS: 5–6). Patients with unsuccessful reperfusion (mTICI: 0–1) showed higher ADMA levels on admission (p = 0.018). However, this association could not be confirmed in the binary logistic regression analysis.

Conclusion Low ADAMTS-13 activity is a predictor of unfavourable outcome in patients with ischaemic stroke undergoing endovascular therapy. Further studies are warranted to elucidate the clinical and potential therapeutic role of ADAMTS-13 in acute ischaemic stroke.

Keywords

thromboinflammation - endovascular therapy - acute ischaemic stroke

* K. Weissenborn and H. Worthmann contributed equally.


 

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