Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy
Pretreatment infarct volume appears to predict clinical outcome after intra-arterial therapy. To confirm the importance of infarct size in patients undergoing intra-arterial therapy, we sought to characterize the relationship between final infarct volume (FIV) and long-term functional outcome in a p...
Gespeichert in:
| Veröffentlicht in: | Stroke (1970) 2012-05, Vol.43 (5), p.1323-1330 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1330 |
|---|---|
| container_issue | 5 |
| container_start_page | 1323 |
| container_title | Stroke (1970) |
| container_volume | 43 |
| creator | Yoo, Albert J. Chaudhry, Zeshan A. Nogueira, Raul G. Lev, Michael H. Schaefer, Pamela W. Schwamm, Lee H. Hirsch, Joshua A. González, R. Gilberto |
| description | Pretreatment infarct volume appears to predict clinical outcome after intra-arterial therapy. To confirm the importance of infarct size in patients undergoing intra-arterial therapy, we sought to characterize the relationship between final infarct volume (FIV) and long-term functional outcome in a prospective cohort of endovascularly treated patients.
From our prospective intra-arterial therapy database, we identified 107 patients with acute ischemic stroke with anterior circulation proximal artery occlusions who underwent final infarct imaging and had 3-month modified Rankin Scale scores. Clinical, imaging, treatment, and outcome data were analyzed.
Mean age was 66.6 years. Median admission National Institutes of Health Stroke Scale score was 17. Reperfusion (Thrombolysis In Cerebral Infarction 2A-3) was achieved in 78 (72.9%) patients. Twenty-seven (25.2%) patients achieved a 3-month good outcome (modified Rankin Scale 0-2), and 30 (28.0%) died. Median FIV was 71.4 cm(3). FIV independently correlated with functional outcome across the entire modified Rankin Scale. In receiver operating characteristic analysis, it was the best discriminator of both good outcome (area under the curve=0.857) and mortality (area under the curve=0.772). A FIV of approximately 50 cm(3) demonstrated the greatest accuracy for distinguishing good versus poor outcome, and a FIV of approximately 90 cm(3) was highly specific for a poor outcome. The interaction term between FIV and age was the only independent predictor of good outcome (P |
| doi_str_mv | 10.1161/STROKEAHA.111.639401 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1009526192</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1009526192</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4945-b4b292bd8ed84495448bc793c5dd3a062de8c065c3ff9b69d33c0491568265f03</originalsourceid><addsrcrecordid>eNpFkctOwzAQRS0EoqXwBwhlg8QmMH7WXoaKRwQSiBa2keM4aqjbFDsB8fcYtdCNx1dzxiPfi9AphkuMBb6azl6eHm6y-yxKfCmoYoD30BBzwlImiNxHQwCqUsKUGqCjEN4BgFDJD9GAEEYExeMhyvNVrb3pkrfW9Uub5CHRyXPz2XbaJddNu9R-YX2S1V0881XndZr5eG9ie9r5dmGT2dx6vf4-Rge1dsGebOsIvd7ezCb36ePTXT7JHlPDFONpyUqiSFlJW0nGFGdMlmasqOFVRTUIUllpQHBD61qVQlWUGmAKcyGJ4DXQEbrYvLv27UdvQ1csm2Csc3pl2z4UGEBxIrAiEWUb1Pg2BG_rYu2b-KPvCBW_Jhb_JkaJi42Jcexsu6Evl7b6H_pzLQLnW0AHo13t9co0YcdxGQPgcrf_q3XRs7Bw_Zf1xdxq182LGAeMxRhSApgAjyr9TYjTH2z_iLQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1009526192</pqid></control><display><type>article</type><title>Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy</title><source>Journals@Ovid Ovid Autoload</source><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Yoo, Albert J. ; Chaudhry, Zeshan A. ; Nogueira, Raul G. ; Lev, Michael H. ; Schaefer, Pamela W. ; Schwamm, Lee H. ; Hirsch, Joshua A. ; González, R. Gilberto</creator><creatorcontrib>Yoo, Albert J. ; Chaudhry, Zeshan A. ; Nogueira, Raul G. ; Lev, Michael H. ; Schaefer, Pamela W. ; Schwamm, Lee H. ; Hirsch, Joshua A. ; González, R. Gilberto</creatorcontrib><description>Pretreatment infarct volume appears to predict clinical outcome after intra-arterial therapy. To confirm the importance of infarct size in patients undergoing intra-arterial therapy, we sought to characterize the relationship between final infarct volume (FIV) and long-term functional outcome in a prospective cohort of endovascularly treated patients.
From our prospective intra-arterial therapy database, we identified 107 patients with acute ischemic stroke with anterior circulation proximal artery occlusions who underwent final infarct imaging and had 3-month modified Rankin Scale scores. Clinical, imaging, treatment, and outcome data were analyzed.
Mean age was 66.6 years. Median admission National Institutes of Health Stroke Scale score was 17. Reperfusion (Thrombolysis In Cerebral Infarction 2A-3) was achieved in 78 (72.9%) patients. Twenty-seven (25.2%) patients achieved a 3-month good outcome (modified Rankin Scale 0-2), and 30 (28.0%) died. Median FIV was 71.4 cm(3). FIV independently correlated with functional outcome across the entire modified Rankin Scale. In receiver operating characteristic analysis, it was the best discriminator of both good outcome (area under the curve=0.857) and mortality (area under the curve=0.772). A FIV of approximately 50 cm(3) demonstrated the greatest accuracy for distinguishing good versus poor outcome, and a FIV of approximately 90 cm(3) was highly specific for a poor outcome. The interaction term between FIV and age was the only independent predictor of good outcome (P<0.0001). The impact of FIV was accentuated in patients <80 years.
Among patients with anterior circulation acute ischemic stroke who undergo intra-arterial therapy, final infarct volume is a critical determinant of 3-month functional outcome and appears suitable as a surrogate biomarker in proof-of-concept intra-arterial therapy trials.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.111.639401</identifier><identifier>PMID: 22426317</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: American Heart Association, Inc</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biomarkers ; Brain Infarction - diagnostic imaging ; Brain Infarction - pathology ; Cohort Studies ; Databases, Factual ; Female ; Fibrinolytic Agents - administration & dosage ; Fibrinolytic Agents - therapeutic use ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Infusions, Intravenous ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neuroimaging - methods ; Neurology ; Predictive Value of Tests ; Prospective Studies ; Retrospective Studies ; Stroke - drug therapy ; Thrombolytic Therapy - methods ; Tissue Plasminogen Activator - administration & dosage ; Tissue Plasminogen Activator - therapeutic use ; Tomography, X-Ray Computed ; Treatment Outcome ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2012-05, Vol.43 (5), p.1323-1330</ispartof><rights>American Heart Association, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4945-b4b292bd8ed84495448bc793c5dd3a062de8c065c3ff9b69d33c0491568265f03</citedby><cites>FETCH-LOGICAL-c4945-b4b292bd8ed84495448bc793c5dd3a062de8c065c3ff9b69d33c0491568265f03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25846258$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22426317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoo, Albert J.</creatorcontrib><creatorcontrib>Chaudhry, Zeshan A.</creatorcontrib><creatorcontrib>Nogueira, Raul G.</creatorcontrib><creatorcontrib>Lev, Michael H.</creatorcontrib><creatorcontrib>Schaefer, Pamela W.</creatorcontrib><creatorcontrib>Schwamm, Lee H.</creatorcontrib><creatorcontrib>Hirsch, Joshua A.</creatorcontrib><creatorcontrib>González, R. Gilberto</creatorcontrib><title>Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Pretreatment infarct volume appears to predict clinical outcome after intra-arterial therapy. To confirm the importance of infarct size in patients undergoing intra-arterial therapy, we sought to characterize the relationship between final infarct volume (FIV) and long-term functional outcome in a prospective cohort of endovascularly treated patients.
From our prospective intra-arterial therapy database, we identified 107 patients with acute ischemic stroke with anterior circulation proximal artery occlusions who underwent final infarct imaging and had 3-month modified Rankin Scale scores. Clinical, imaging, treatment, and outcome data were analyzed.
Mean age was 66.6 years. Median admission National Institutes of Health Stroke Scale score was 17. Reperfusion (Thrombolysis In Cerebral Infarction 2A-3) was achieved in 78 (72.9%) patients. Twenty-seven (25.2%) patients achieved a 3-month good outcome (modified Rankin Scale 0-2), and 30 (28.0%) died. Median FIV was 71.4 cm(3). FIV independently correlated with functional outcome across the entire modified Rankin Scale. In receiver operating characteristic analysis, it was the best discriminator of both good outcome (area under the curve=0.857) and mortality (area under the curve=0.772). A FIV of approximately 50 cm(3) demonstrated the greatest accuracy for distinguishing good versus poor outcome, and a FIV of approximately 90 cm(3) was highly specific for a poor outcome. The interaction term between FIV and age was the only independent predictor of good outcome (P<0.0001). The impact of FIV was accentuated in patients <80 years.
Among patients with anterior circulation acute ischemic stroke who undergo intra-arterial therapy, final infarct volume is a critical determinant of 3-month functional outcome and appears suitable as a surrogate biomarker in proof-of-concept intra-arterial therapy trials.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Brain Infarction - diagnostic imaging</subject><subject>Brain Infarction - pathology</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Fibrinolytic Agents - administration & dosage</subject><subject>Fibrinolytic Agents - therapeutic use</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neuroimaging - methods</subject><subject>Neurology</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Stroke - drug therapy</subject><subject>Thrombolytic Therapy - methods</subject><subject>Tissue Plasminogen Activator - administration & dosage</subject><subject>Tissue Plasminogen Activator - therapeutic use</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkctOwzAQRS0EoqXwBwhlg8QmMH7WXoaKRwQSiBa2keM4aqjbFDsB8fcYtdCNx1dzxiPfi9AphkuMBb6azl6eHm6y-yxKfCmoYoD30BBzwlImiNxHQwCqUsKUGqCjEN4BgFDJD9GAEEYExeMhyvNVrb3pkrfW9Uub5CHRyXPz2XbaJddNu9R-YX2S1V0881XndZr5eG9ie9r5dmGT2dx6vf4-Rge1dsGebOsIvd7ezCb36ePTXT7JHlPDFONpyUqiSFlJW0nGFGdMlmasqOFVRTUIUllpQHBD61qVQlWUGmAKcyGJ4DXQEbrYvLv27UdvQ1csm2Csc3pl2z4UGEBxIrAiEWUb1Pg2BG_rYu2b-KPvCBW_Jhb_JkaJi42Jcexsu6Evl7b6H_pzLQLnW0AHo13t9co0YcdxGQPgcrf_q3XRs7Bw_Zf1xdxq182LGAeMxRhSApgAjyr9TYjTH2z_iLQ</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Yoo, Albert J.</creator><creator>Chaudhry, Zeshan A.</creator><creator>Nogueira, Raul G.</creator><creator>Lev, Michael H.</creator><creator>Schaefer, Pamela W.</creator><creator>Schwamm, Lee H.</creator><creator>Hirsch, Joshua A.</creator><creator>González, R. Gilberto</creator><general>American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy</title><author>Yoo, Albert J. ; Chaudhry, Zeshan A. ; Nogueira, Raul G. ; Lev, Michael H. ; Schaefer, Pamela W. ; Schwamm, Lee H. ; Hirsch, Joshua A. ; González, R. Gilberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4945-b4b292bd8ed84495448bc793c5dd3a062de8c065c3ff9b69d33c0491568265f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Brain Infarction - diagnostic imaging</topic><topic>Brain Infarction - pathology</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Fibrinolytic Agents - administration & dosage</topic><topic>Fibrinolytic Agents - therapeutic use</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neuroimaging - methods</topic><topic>Neurology</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Stroke - drug therapy</topic><topic>Thrombolytic Therapy - methods</topic><topic>Tissue Plasminogen Activator - administration & dosage</topic><topic>Tissue Plasminogen Activator - therapeutic use</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoo, Albert J.</creatorcontrib><creatorcontrib>Chaudhry, Zeshan A.</creatorcontrib><creatorcontrib>Nogueira, Raul G.</creatorcontrib><creatorcontrib>Lev, Michael H.</creatorcontrib><creatorcontrib>Schaefer, Pamela W.</creatorcontrib><creatorcontrib>Schwamm, Lee H.</creatorcontrib><creatorcontrib>Hirsch, Joshua A.</creatorcontrib><creatorcontrib>González, R. Gilberto</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoo, Albert J.</au><au>Chaudhry, Zeshan A.</au><au>Nogueira, Raul G.</au><au>Lev, Michael H.</au><au>Schaefer, Pamela W.</au><au>Schwamm, Lee H.</au><au>Hirsch, Joshua A.</au><au>González, R. Gilberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>43</volume><issue>5</issue><spage>1323</spage><epage>1330</epage><pages>1323-1330</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Pretreatment infarct volume appears to predict clinical outcome after intra-arterial therapy. To confirm the importance of infarct size in patients undergoing intra-arterial therapy, we sought to characterize the relationship between final infarct volume (FIV) and long-term functional outcome in a prospective cohort of endovascularly treated patients.
From our prospective intra-arterial therapy database, we identified 107 patients with acute ischemic stroke with anterior circulation proximal artery occlusions who underwent final infarct imaging and had 3-month modified Rankin Scale scores. Clinical, imaging, treatment, and outcome data were analyzed.
Mean age was 66.6 years. Median admission National Institutes of Health Stroke Scale score was 17. Reperfusion (Thrombolysis In Cerebral Infarction 2A-3) was achieved in 78 (72.9%) patients. Twenty-seven (25.2%) patients achieved a 3-month good outcome (modified Rankin Scale 0-2), and 30 (28.0%) died. Median FIV was 71.4 cm(3). FIV independently correlated with functional outcome across the entire modified Rankin Scale. In receiver operating characteristic analysis, it was the best discriminator of both good outcome (area under the curve=0.857) and mortality (area under the curve=0.772). A FIV of approximately 50 cm(3) demonstrated the greatest accuracy for distinguishing good versus poor outcome, and a FIV of approximately 90 cm(3) was highly specific for a poor outcome. The interaction term between FIV and age was the only independent predictor of good outcome (P<0.0001). The impact of FIV was accentuated in patients <80 years.
Among patients with anterior circulation acute ischemic stroke who undergo intra-arterial therapy, final infarct volume is a critical determinant of 3-month functional outcome and appears suitable as a surrogate biomarker in proof-of-concept intra-arterial therapy trials.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>22426317</pmid><doi>10.1161/STROKEAHA.111.639401</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0039-2499 |
| ispartof | Stroke (1970), 2012-05, Vol.43 (5), p.1323-1330 |
| issn | 0039-2499 1524-4628 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1009526192 |
| source | Journals@Ovid Ovid Autoload; MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Age Factors Aged Aged, 80 and over Biological and medical sciences Biomarkers Brain Infarction - diagnostic imaging Brain Infarction - pathology Cohort Studies Databases, Factual Female Fibrinolytic Agents - administration & dosage Fibrinolytic Agents - therapeutic use Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Infusions, Intravenous Magnetic Resonance Imaging Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neuroimaging - methods Neurology Predictive Value of Tests Prospective Studies Retrospective Studies Stroke - drug therapy Thrombolytic Therapy - methods Tissue Plasminogen Activator - administration & dosage Tissue Plasminogen Activator - therapeutic use Tomography, X-Ray Computed Treatment Outcome Vascular diseases and vascular malformations of the nervous system |
| title | Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T07%3A33%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Infarct%20Volume%20Is%20a%20Pivotal%20Biomarker%20After%20Intra-Arterial%20Stroke%20Therapy&rft.jtitle=Stroke%20(1970)&rft.au=Yoo,%20Albert%20J.&rft.date=2012-05-01&rft.volume=43&rft.issue=5&rft.spage=1323&rft.epage=1330&rft.pages=1323-1330&rft.issn=0039-2499&rft.eissn=1524-4628&rft.coden=SJCCA7&rft_id=info:doi/10.1161/STROKEAHA.111.639401&rft_dat=%3Cproquest_cross%3E1009526192%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1009526192&rft_id=info:pmid/22426317&rfr_iscdi=true |