Early antithrombotic therapy in patients with postinterventional cerebral hyperdensity reduces early neurological deterioration after mechanical thrombectomy

• Published in: BMC neurology Vol. 23; no. 1; p. 443
• Main Authors: Luo, Yunhe, Chu, Min, Wang, Daosheng, Gu, Xin, Wang, Delong, Zheng, Jin, Zhao, Jing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.12.2023; BioMed Central; BMC
• Subjects: Acute ischemic Stroke; Anticoagulants; Antithrombotic therapy; Aspirin; Brain Ischemia - complications; Cardiac arrhythmia; Care and treatment; Development and progression; Diagnosis; Dosage and administration; Early neurological deterioration; Fibrinolytic Agents - therapeutic use; Heart failure; Hospitals; Humans; Ischemia; Ischemic Stroke - etiology; Mechanical thrombectomy; Medical imaging; Neurologic manifestations of general diseases; Postinterventional cerebral hyperdensity; Prevention; Retrospective Studies; Risk factors; Statistical analysis; Stroke; Stroke (Disease); Stroke - complications; Testing; Thrombectomy - adverse effects; Thrombolytic drugs; Tomography; Treatment Outcome; Veins & arteries; China; Acute ischemic Stroke; Antithrombotic therapy; Mechanical thrombectomy; Early neurological deterioration; Postinterventional cerebral hyperdensity
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-023-03497-9

Initiation of early antithrombotic therapy after acute ischemic stroke (AIS) is crucial. We aimed to investigate whether early antithrombotic therapy influences early neurological deterioration (END) in AIS patients with postinterventional cerebral hyperdensity (PCHD) immediately after mechanical thrombectomy (MT). We retrospectively analyzed 108 consecutive anterior circulation AIS patients with PCHD immediately after MT. All patients were divided into END group and non-END group and END was defined as an increase of four points or more on the postinterventional National Institutes of Health Stroke Scale (NIHSS) score within the first 72 h after MT. Early antithrombotic therapy was defined as patients with PCHD who received antithrombotic therapy within 24 h after MT. Statistical analyses were performed to evaluate the association between early antithrombotic therapy and the risk of END. Among 108 patients, 27 (25%) patients developed END. Multivariate regression analysis revealed that early use of antithrombotic therapy (OR = 0.229, 95%CI = 0.083-0.626, P = 0.004) was an independent protector of END and postinterventional low density shadow exceeding 1/3 of the vascular territory (OR = 4.000, 95%CI = 1.157-13.834, P = 0.029) was an independent risk factor for END. Antithrombotic therapy within 24 h after MT maybe associated with the reduced risk of END in anterior circulation AIS patients with PCHD.