Residual inflammatory risk predicts long-term outcomes following stenting for symptomatic intracranial atherosclerotic stenosis

作者全名："Yu, Ying; Lou, Yake; Pan, Yuesong; Yan, Long; Fu, Weilun; Hou, Zhikai; Cui, Rongrong; Miao, Zhongrong; Wang, Yongjun; Lou, Xin; Ma, Ning"

作者地址："[Yu, Ying; Yan, Long; Fu, Weilun; Hou, Zhikai; Miao, Zhongrong; Ma, Ning] Capital Med Univ, Beijing Tiantan Hosp, Dept Intervent Neuroradiol, Beijing, Peoples R China; [Yu, Ying; Pan, Yuesong; Yan, Long; Fu, Weilun; Hou, Zhikai; Miao, Zhongrong; Wang, Yongjun; Ma, Ning] Beijing Tiantan Hosp, China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [Yu, Ying; Miao, Zhongrong; Ma, Ning] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [Lou, Yake] Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, Chongqing, Peoples R China; [Cui, Rongrong] Beijing Daxing Dist Peoples Hosp, Dept Neurol, Beijing, Peoples R China; [Lou, Xin] Chinese Peoples Liberat Army Gen Hosp, Radiol, Beijing, Peoples R China"

通信作者："Ma, N (通讯作者)，Capital Med Univ, Beijing Tiantan Hosp, Dept Intervent Neuroradiol, Beijing, Peoples R China.; Ma, N (通讯作者)，Beijing Tiantan Hosp, China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China.; Ma, N (通讯作者)，Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China."

来源：STROKE AND VASCULAR NEUROLOGY

ESI学科分类：　

WOS号：WOS:001153724500001

JCR分区：Q1

影响因子：4.4

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：atherosclerosis; inflammation; risk factors; stents; stroke

摘要："Background and purpose Residual inflammatory risk (RIR) can predict the unfavourable outcomes in patients with minor ischaemic stroke. However, the impact of preprocedural RIR on long-term outcomes in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) who underwent stenting remains understudied. Methods This retrospective, single-centre cohort study evaluated consecutive patients with severe sICAS who underwent intracranial stenting. Patients were categorised into four groups based on preprocedural high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP >= 3 mg/L and LDL-C >= 2.6 mmol/L), RIR (hs-CRP >= 3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C >= 2.6 mmol/L) and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). The long-term clinical outcomes included recurrent ischaemic stroke and death. The long-term imaging outcomes consisted of in-stent restenosis (ISR) and symptomatic ISR (sISR) after stenting. Results In this study, 952 patients were included, with 751 (78.9%) being male. Forty-six cases were categorised into the RCIR group, 211 into the RIR group, 107 into the RCR group and 588 into the NRR group. Patients with RCIR (adjusted HR 6.163; 95% CI 2.603 to 14.589; p<0.001) and RIR (adjusted HR 2.205; 95% CI 1.294 to 3.757; p=0.004) had higher risks of recurrent ischaemic stroke than those with NRR during the 54 months of median follow-up time. Patients with RCIR (adjusted HR 3.604; 95% CI 1.431 to 9.072; p=0.007) were more likely to occur ISR, and patients in the RIR group showed a significant increase in the risk of sISR (adjusted HR 2.402; 95% CI 1.078 to 5.351; p=0.032) compared with those in the NRR group with a median follow-up time of 11.9 months. Conclusions In patients with sICAS, preprocedural RIR may predict long-term recurrent ischaemic stroke, ISR and sISR following intracranial stenting."

基金机构："National Natural Science Foundation of China [82171894, 81825012, 81730048]"

基金资助正文："This work was supported by the National Natural Science Foundation of China (contract grant number: 82171894 to NM and contract grant numbers: 81825012, 81730048 to XL)."