The presence of leukoaraiosis enhances the association between sTWEAK and hemorrhagic transformation
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Identificadores
URI: http://hdl.handle.net/20.500.11940/16619
PMID: 33022893
DOI: 10.1002/acn3.51171
ISSN: 2328-9503
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Fecha de publicación
2020Título de revista
ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY
Tipo de contenido
Journal Article
DeCS
anciano | reperfusión | estudios de seguimiento | hemorragia cerebral | estudios retrospectivos | mediana edad | imagen por resonancia magnética | humanos | leucoaraiosisMeSH
Reperfusion | Middle Aged | Humans | Cerebral Hemorrhage | Magnetic Resonance Imaging | Leukoaraiosis | Follow-Up Studies | Retrospective Studies | AgedResumen
OBJECTIVE: To investigate whether elevated serum levels of sTWEAK (soluble tumor necrosis factor-like inducer of apoptosis) might be involved in a higher frequency of symptomatic hemorrhagic transformation (HT) through the presence of leukoaraiosis (LA) in patients with acute ischemic stroke (IS) undergoing reperfusion therapies. METHODS: This is a retrospective observational study. The primary endpoint was to study the sTWEAK-LA-HT relationship by comparing results with biomarkers associated to HT and evaluating functional outcome at 3-months. Clinical factors, neuroimaging variables and biomarkers associated to inflammation, endothelial/atrial dysfunction or blood-brain barrier damage were also investigated. RESULTS: We enrolled 875 patients (mean age 72.3 +/- 12.2 years; 46.0% women); 710 individuals underwent intravenous thrombolysis, 87 endovascular therapy and 78 both. HT incidence was 32%; LA presence was 75.4%. Patients with poor functional outcome at 3-months showed higher sTWEAK levels at admission (9844.2 [7460.4-12,542.0] vs. 2717.3 [1489.7-5852.3] pg/mL, P < 0.0001). By means of logistic regression models, PDGF-CC and sTWEAK were associated with mechanisms linked simultaneously to HT and LA. Serum sTWEAK levels at admission >/=6700 pg/mL were associated with an odds ratio of 13 for poor outcome at 3-months (OR: 13.6; CI 95%: 8.2-22.6, P < 0.0001). CONCLUSIONS: Higher sTWEAK levels are independently associated with HT and poor functional outcome in patients with IS undergoing reperfusion therapies through the presence of LA. sTWEAK could become a therapeutic target to reduce HT incidence in patients with IS.
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