Inflammatory biomarkers may be associated with poor outcomes after mechanical thrombectomy

Abstract

Abstract Background: Mechanical thrombectomy (MT) has become the mainstay of treatment for acute ischemic stroke (AIS) in recent years. This case-control study aimed to identify the pivotal role of inflammation in the prognosis of AIS patients after MT. Methods: Altogether, 70 AIS patients who underwent MT were retrospectively recruited for this study. ROC analysis was performed to demonstrate the sensitivity and specificity of the inflammatory variables for predicting prognosis. A meta-analysis was further performed to pool the published results together. Stata software was used for analysis in this study. Results: A total of 70 patients were enrolled in this study. There was no differences in pre-MT inflammatory biomarkers between patients who survived and those who died, as well as patients with mRS 0–2 and mRS ≥ 3. In contrast, post-MT CRP levels might be a potential parameter to predict death after thrombectomy (AUC, 95%CI, 0.737, 0.587-0.887; p=0.005; optimal cutoff value=4.565). Moreover, post-MT monocyte count might be an appropriate parameter to predict poor long-term prognosis after thrombectomy (AUC, 95%CI, 0.704, 0.575-0.833; p=0.017; optimal cutoff value=0.345). A meta-analysis revealed that the pre-MT inflammatory indices, including WBC count (WMD, 95%CI, 1.32, 1.01—1.63), neutrophil count (1.23, 0.95—1.51), monocyte count (0.05, 0.02—0.09), NLR (2.42, 1.98—2.87) and PLR (24.65, 7.99—41.32), were higher in patients with 3-month mRS ≥ 3, and the lymphocyte count (-0.28, -0.40—-0.16) was lower in this cohort. Conclusions: Inflammatory indices were significantly associated with the prognosis of patients undergoing MT, especially post-MT CRP and monocyte count, which can predict long-term outcomes.