Increased peripheral leukocyte aggravates brain injury and leads to poor outcome in stroke patients receiving intravenous thrombolysis: A study based on clinical evidence

Whether the dynamic development of peripheral inflammation aggravates brain injury and leads to poor outcome in stroke patients receiving intravenous thrombolysis (IVT), remains unclear and warrants further study. In this study, total of 1034 patients with acute ischemic stroke who underwent IVT were enrolled. Serum leukocyte variation (whether increase from baseline to 24 h after IVT), National Institutes of Health Stroke Scale (NIHSS), infarct volume, early neurologic deterioration (END), the unfavorable outcome at 3-month (modified Rankin Scale [mRS] score ≥3) and mortality were recorded. Serum brain injury biomarkers, including Glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase L1 (UCH-L1), S100<i>β</i>, neuron-specific enolase (NSE), were measured to reflect the extent of brain injury. We found that patients with increased serum leukocytes had elevated brain injury biomarkers (GFAP, UCH-L1, and S100<i>β</i>), larger infarct volume, higher 24 h NIHSS, higher proportion of END, unfavorable outcome and mortality. Furthermore, an increase in serum leukocytes was independently associated with infarct volume, 24 h NIHSS, END, and unfavorable outcome at 3 months, and serum UCH-L1, S100<i>β</i>, and NSE levels. These results suggest that an increase in serum leukocytes indicates severe brain injury and may be used to predict the outcome of patients with ischemic stroke who undergo IVT.

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Publication Details

Journal
Journal of Cerebral Blood Flow & Metabolism
Published
2024-09-05
DOI
https://doi.org/10.1177/0271678x241281020
Citations
2
Primary Topic
Acute Ischemic Stroke Management
Type
article
Field-Weighted Citation Impact
0.77

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article

Increased peripheral leukocyte aggravates brain injury and leads to poor outcome in stroke patients receiving intravenous thrombolysis: A study based on clinical evidence

Zhibo Chen, Yongfei Jiang, Shuang Yu, Yan Jia et al.
2 citations
Journal of Cerebral Blood Flow & Metabolism
Acute Ischemic Stroke Management
0.77
article

Increased peripheral leukocyte aggravates brain injury and leads to poor outcome in stroke patients receiving intravenous thrombolysis: A study based on clinical evidence

Zhibo Chen, Yongfei Jiang, Shuang Yu, Yan Jia, Song Li, Yang Zheng, Reziya Abuduxukuer, Yang Qu, Guangcai Li, Xiankun Zhang, Chunli Jiang, Zhen‐Ni Guo, Thanh N. Nguyen, Yi Yang, Dongsheng Ju, Ligang Jiang, Ying He, Zhi-Mei Yuan, Jianhua Gao, Huimin Jin, Junmin Wang, Peng Zhang, Xiaodong Liu, Kejia Zhang, Jinhua Chen, Xiuping Liu, Liang Liu, Yingbin Qi, Yumei Chen, Yu Zhang, Chunying Li, Bai-Jing Zhang, Ling He, Rui-Hong Teng, Xue Liu, Li-Li Zhao, Yun-Fei Ba, Ji-Liang Gu, An-Ying Wang, Chen-Peng Dong, Xun-Juan Zhang, Zhong-Rui Pei, Lijuan Wang, Li Liu
article en
2 citations

Abstract

Whether the dynamic development of peripheral inflammation aggravates brain injury and leads to poor outcome in stroke patients receiving intravenous thrombolysis (IVT), remains unclear and warrants further study. In this study, total of 1034 patients with acute ischemic stroke who underwent IVT were enrolled. Serum leukocyte variation (whether increase from baseline to 24 h after IVT), National Institutes of Health Stroke Scale (NIHSS), infarct volume, early neurologic deterioration (END), the unfavorable outcome at 3-month (modified Rankin Scale [mRS] score ≥3) and mortality were recorded. Serum brain injury biomarkers, including Glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase L1 (UCH-L1), S100<i>β</i>, neuron-specific enolase (NSE), were measured to reflect the extent of brain injury. We found that patients with increased serum leukocytes had elevated brain injury biomarkers (GFAP, UCH-L1, and S100<i>β</i>), larger infarct volume, higher 24 h NIHSS, higher proportion of END, unfavorable outcome and mortality. Furthermore, an increase in serum leukocytes was independently associated with infarct volume, 24 h NIHSS, END, and unfavorable outcome at 3 months, and serum UCH-L1, S100<i>β</i>, and NSE levels. These results suggest that an increase in serum leukocytes indicates severe brain injury and may be used to predict the outcome of patients with ischemic stroke who undergo IVT.

Journal of Cerebral Blood Flow & MetabolismVol. 45(3)
Boston University (US), Boston Medical Center (US), Jilin University (CN), People 's Hospital of Jilin Province (CN), Jilin City Central Hospital (CN), Shengli Oilfield Central Hospital (CN), First Hospital of Jilin University (CN), Songjiang District Central Hospital (CN), Changchun Children's Hospital (CN), Jilin Medical University (CN), Brain Hospital of Jilin (CN)
National Natural Science Foundation of China, People's Government of Jilin Province, Jilin University, First Hospital of Jilin University
Good health and well-being
Openalex Percentile: Top 26%
Acute Ischemic Stroke Management
0.77
DOIOpen Access PDFOpenAlex
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