Endothelial NO synthase 786T/T polymorphism increases hemorrhagic transformation after endovascular thrombectomy
Por:
De la Riva, P, Rodriguez-Antiguedad, J, Gomez, V, Arenaza, G, Gorostidi, A, Diez, N, De Arce, A, Martinez-Zabaleta, M, Gonzalez, F, Luttich, A, Garmendia, E, Sola, A, Larrea, JA, Bergareche, A, Sobrino, T
Publicada:
1 dic 2022
Ahead of Print:
1 sep 2022
Resumen:
Background and purpose: This study examined whether the 786 NOS3 polymorphism is associated with the risk of hemorrhagic transformation (HT) in stroke patients with anterior large vessel occlusion (ALVO) treated using endovascular thrombectomy (EVT).Methods: We performed an observational cohort study that included 118 patients with ALVO who underwent EVT. HT was assessed in follow-up CT and MRI. HT and non-HT patients were compared in terms of the 786 NOS3 polymorphism, flow mediated dilation (FMD) values within 3 days after the stroke, and collateral status based on three grading scales. Demographics, vascular risk factors, additional radiological data including ASPECT score, thrombus length and infarct size, and EVT procedure and outcome variables were also included.Results: Radiological HT occurred in 55 (46.6%) patients and the 786T/T NOS3 polymorphism was associated with HT (unadjusted OR of 2.33, 95%CI: 1.05-5.20, adjusted OR of 3.14, 95%CI: 1.16-8.54). Collateral status and systemic endothelial function assessed by FMD were not mediators of this relationship as no differences were seen in the median FMD percentage values or collateral status between NOS3 genotypes.Conclusions: Our results suggest that genetic variations affecting the NO pathway, such as the 786 NOS3 poly-morphism, may contribute to individual variability in the occurrence of HT and these results support involve-ment of this pathway in the pathogenesis of ischemia-reperfusion injury after EVT.
Filiaciones:
De la Riva, P:
Donostia Univ Hosp, Neurol Dept, Paseo Doctor Beguiristain S-N, San Sebastian 20014, Spain
Rodriguez-Antiguedad, J:
Santa Creu & St Pau Hosp, Res Inst, Barcelona, Spain
Gomez, V:
Donostia Univ Hosp, Radiol Dept, San Sebastian, Spain
Arenaza, G:
Donostia Univ Hosp, Radiol Dept, San Sebastian, Spain
Gorostidi, A:
Biodonostia Res Inst, Neurodegenerat Dis, San Sebastian, Spain
Diez, N:
Donostia Univ Hosp, Neurol Dept, Paseo Doctor Beguiristain S-N, San Sebastian 20014, Spain
De Arce, A:
Donostia Univ Hosp, Neurol Dept, Paseo Doctor Beguiristain S-N, San Sebastian 20014, Spain
Martinez-Zabaleta, M:
Donostia Univ Hosp, Neurol Dept, Paseo Doctor Beguiristain S-N, San Sebastian 20014, Spain
Gonzalez, F:
Donostia Univ Hosp, Neurol Dept, Paseo Doctor Beguiristain S-N, San Sebastian 20014, Spain
Luttich, A:
Donostia Univ Hosp, Radiol Dept, San Sebastian, Spain
Garmendia, E:
Donostia Univ Hosp, Radiol Dept, San Sebastian, Spain
Sola, A:
Donostia Univ Hosp, Radiol Dept, San Sebastian, Spain
Larrea, JA:
Donostia Univ Hosp, Radiol Dept, San Sebastian, Spain
Bergareche, A:
Donostia Univ Hosp, Neurol Dept, Paseo Doctor Beguiristain S-N, San Sebastian 20014, Spain
Sobrino, T:
Santiago Clin Univ Hosp, Clin Neurosci Res Lab, Santiago De Compostela, Spain
|