Clinical trial NCT06545591: Predictive Role of sTREM in Endovascular Thrombectomy Outcomes
Official title: Soluble Soluble Triggering Receptors Expressed on Myeloid Cells (sTREM) Predict Outcomes in Stroke Patients Receiving Endovascular Thrombectomy
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Acute Ischemic Stroke
Keywords: Thrombectomy
soluble TREM-1
soluble TREM-2
Lead sponsor: The Affiliated Hospital of Xuzhou Medical University
Sponsor class: OTHER
First posted: 2024-08-09
Enrollment: 300
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: There will be 200 patients with stroke who underwent EVT (Endovascular Therapy), 50 patients with non--EVT stroke and 50 non--stroke controls.

Brief summary: Soluble triggering receptor expressed on myeloid cells (sTREM), which reflects microglia activation, has been reported closely associated with neuronal injury and neuroinflammation. This study is to investigatethe prognostic roles of sTREM (sTREM1 and sTREM2) in patients with ischemic stroke who underwent endovascular thrombectomy (EVT).

Detailed description: For acute ischemic stroke, the current treatment strategy involves timely recanalization by intravenous thrombolysis and endovascular thrombectomy (EVT). Patients receiving EVT are more likely to achieve successful revascularization and long--term functional independence compared with those receiving standard medical treatment.1 In patients receiving EVT, significant predictors of a favorable functional outcome include minor initial stroke severity, successful recanalization, and shorter onset--to--treatment time. However, unfavorable outcomes can occur even after early successful recanalization in some cases.Triggering receptors expressed on myeloid cells (TREM-1 and TREM-2) are a familyof receptors involved in the immune system expressed on a variety of innate cells of the myeloid lineage, including microglia. sTREM, which reflects microglia activation, has been reported closely associated with neuronal injury and neuroinflammation. We enrolled adult patients with stroke who received EVT, with blood sampling immediately before (T1) and after EVT (T2), and at 24 hours after EVT (T3). Non--stroke controls and patients with non--EVT stroke were also enrolled. The plasma concentration of sTREM1 and sTREM2 were analyzed by ELISA. The medical information, image findings and levels of plasma sTREM1 and sTREM2 were analyzed to clarify the association with poor functional outcome (modified Rankin Scale 4-6) at 3 months after stroke.

Eligibility criteria: Inclusion Criteria:

* Patients \> 18 years old.
* Patients with acute large vessel occlusion within 24 hours of onset who will receive endovascular treatment.

Exclusion Criteria:

* Impossibility of getting a blood sample.
* Impossibility of performing the test (Invalid results).
* Refusal to provide the informed consent by the patient/relative.

Primary outcomes:
measure: Dynamic changes in plasma levels of sTREM-1 and sTREM-2 following Endovascular Therapy
timeFrame: From baseline to immediately, 24 hours, 3 days, and 7 days after Endovascular Therapy
Secondary outcomes:
measure: favourable functional outcome, defined as modified Rankin Scale (mRS) 0-2
timeFrame: 90 days
measure: excellent functional outcome, defined as modified Rankin Scale (mRS) 0-1
timeFrame: 30 days
measure: early neurological improvement, defined as 4 or more decrease in National Institute of Health stroke scale (NIHSS)
timeFrame: 24 hours
measure: Hemorrhagic transformation
timeFrame: 72 hours
Other outcomes:
Locations:
city: Xuzhou
country: China
facility: Department of Neurology
state: Jiangsu
Study officials:
References: