高纤维蛋白和血小板凝块可预测活动性癌症患者血栓切除术后中风复发或死亡率。
High fibrin and platelet clot predicts stroke recurrence or mortality after thrombectomy in patients with active cancer.
发表日期:2024 Aug 31
作者:
Chuan-Hsiu Fu, Chih-Hao Chen, Yen-Heng Lin, Chung-Wei Lee, Li-Kai Tsai, Sung-Chun Tang, Chia-Tung Shun, Jiann-Shing Jeng
来源:
Journal of NeuroInterventional Surgery
摘要:
富含纤维蛋白和血小板 (FP) 的凝块已被证明与癌症相关的中风有关。本研究旨在探讨血栓成分对经历过中风并接受血管内血栓切除术 (EVT) 的癌症患者的临床结果的预后作用。我们纳入了 2015 年 3 月至 2021 年 11 月期间接受 EVT 的急性缺血性中风患者。这些患者分为三类群体:患有活动性癌症的人、患有非活动性癌症的人以及没有癌症的人。血块中 FP 的百分比在苏木精和伊红染色下进行定量。主要结局定义为中风事件后 90 天内的任何中风复发或死亡。该研究共纳入了 420 名血栓回收患者。该队列由 50 名活动性癌症患者、23 名非活动性癌症患者和 347 名非癌症患者组成。与其他两组相比,从活动性癌症患者中取出的血栓中 FP 的百分比显着更高。与其他组相比,活动性癌症组的患者表现出较高的主要结局发生率。调整临床变量后,血栓中较高的 FP 百分比仍然与活动性癌症组的主要结局显着相关(调整后的比值比 (aOR) =1.03 (1.00-1.06),P=0.028),但在其他组中则不然两组。在接受 EVT 的中风患者中,具有较高 FP 百分比的血栓不仅可以识别患有活动性癌症的个体,还可以预测 90 天内中风复发或死亡率。© 作者(或其雇主)2024。否商业再利用。请参阅权利和权限。英国医学杂志出版。
Fibrin and platelet (FP)-rich clots have been shown to be associated with cancer-related stroke. This study aims to investigate the prognostic role of thrombus composition in clinical outcomes among cancer patients who experienced stroke and received endovascular thrombectomy (EVT).We included acute ischemic stroke patients who underwent EVT between March 2015 and November 2021. These patients were categorized into three groups: those with active cancer, those with non-active cancer, and those without cancer. The percentages of FP in clots were quantified under hematoxylin and eosin staining. The primary outcome was defined as any stroke recurrence or mortality within 90 days following the index stroke event.A total of 420 patients with retrieved clots were included in the study. This cohort comprised 50 patients with active cancer, 23 patients with non-active cancer, and 347 patients without cancer. The percentage of FP was significantly higher in thrombi retrieved from patients with active cancer compared with the other two groups. Patients in the active cancer group exhibited a higher rate of the primary outcome compared with the other groups. After adjusting for clinical variables, a higher percentage of FP in thrombi remained significantly associated with the primary outcome in the active cancer group (adjusted odds ratio (aOR) =1.03 (1.00-1.06), P=0.028), but not in the other two groups.Among stroke patients receiving EVT, thrombi with a higher percentage of FP not only identify individuals with active cancer but also predict stroke recurrence or mortality within 90 days.© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.