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

Ramona Schuppner; Meike Dirks; Gerrit M. Grosse; Matthias Böckmann; Friedrich Goetz; Thomas Pasedag; Stefanie M. Bode-Böger; Jens Martens-Lobenhoffer; Ulrich Budde; Heinrich Lanfermann; Ralf Lichtinghagen; Karin Weissenborn; Hans Worthmann

doi:10.1055/s-0038-1637732

Thrombosis and Haemostasis, Table of Contents

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

Authors

Ramona Schuppner

¹Department of Neurology, Hannover Medical School, Hannover, Germany
Meike Dirks

¹Department of Neurology, Hannover Medical School, Hannover, Germany
Gerrit M. Grosse

¹Department of Neurology, Hannover Medical School, Hannover, Germany
Matthias Böckmann

¹Department of Neurology, Hannover Medical School, Hannover, Germany
Friedrich Goetz

²Department of Neuroradiology, Hannover Medical School, Hannover, Germany
Thomas Pasedag

¹Department of Neurology, Hannover Medical School, Hannover, Germany

³Department of Psychiatry, Kliniken der Region Hannover, Langenhagen, Germany
Stefanie M. Bode-Böger

⁴Department of Clinical Pharmacology, Otto-von-Guericke University, Magdeburg, Germany
Jens Martens-Lobenhoffer

⁴Department of Clinical Pharmacology, Otto-von-Guericke University, Magdeburg, Germany
Ulrich Budde

⁵Medilys Laboratory, Asklepios Clinic Altona, Hamburg, Germany
Heinrich Lanfermann

²Department of Neuroradiology, Hannover Medical School, Hannover, Germany
Ralf Lichtinghagen

⁶Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
Karin Weissenborn^*

¹Department of Neurology, Hannover Medical School, Hannover, Germany
Hans Worthmann^*

¹Department of Neurology, Hannover Medical School, Hannover, Germany

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

Full Text

References

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