Acute Stroke Clinical Trial
Official title:
Neutrophil Extracellular Traps and Thrombolysis in the Acute Stroke
The purpose of the study was to investigate the correlation between the nucleosome concentration and the rate of recanalization after thrombolysis. All patients were admitted to the Stroke Unit at the University Hospital Sainte-Anne where they received standard stroke care. The investigators included all patients treated or not by intravenous thrombolysis for anterior circulation stroke with or without vessel occlusion. Exclusion criteria were neoplasms, chronic inflammatory diseases and cytostatic therapy at the time of stroke and stroke-specifics symptoms that had started earlier than 4.5 hours before admission.
Neutrophil extracellular traps (NETs) were measured in serum at the time of hospitalization,
then at 4 hours, 24 hours and 72 hours after stroke. Because of nucleosome instability, a
strict preanalytical protocol was followed. Blood samples were centrifuged within 1-2 h after
blood drawing. A strict preanalytical protocol was followed including early centrifugation of
the samples and storage at - 80°C. NETs were quantified in batches containing all samples
from a patient using the detection of MPO (myeloperoxidase) then the Cell-Death-Detection
ELISAPLUS (Roche Diagnostics, Germany) as described earlier. Nucleosomes were quantified in
relative arbitrary units (AU). Blood samples from each patient were measured within the same
run to improve the comparability of the results.
For statistical analysis, various variables of nucleosomes were considered, such as the
absolute concentrations determined at admission, at 24 hours and at 72 hours after stroke.
Influence of nucleosome concentration on recanalization was tested. Continuous correlations
of nucleosomes and infarction volume, nucleosomes and clot size, as well as of infarction
volume and NIHSS were calculated by Spearman's rank correlation together with the 95%
confidence interval. A p value < 0.05 was considered statistically significant.
The extent of the morphological damage was determined at time of admission to the hospital
and 24 hours after thrombolysis by diffusion-weighted magnetic resonance imaging (MRI). The
pretreat¬ment and follow-up DWI lesions was segmented using interactive tools based on DWI
signal intensity thresholding within a 3-dimensional mask encompassing the apparent area of
bright DWI signal intensity and morphometric filtering. The clot location and length were
assessed on the susceptibility vessel sign on T2* as describe earlier.
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