The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment

Background: Age is a well-established predictor of poor prognosis in patients with ischemic stroke (IS) undergoing endovascular treatment (EVT). The endothelium plays a central role in the pathophysiology of IS, and its function can be evaluated using various methods. This study aims to investigate...

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Autores: de la Riva, P, Rodríguez-Antigüedad, J, Marta-Enguita, J, Gómez, V, Arenaza, G, Gorostidi, A, Díez, N, de Arce, A, Garmendia, E, Zumeta, E, Larrea, JA, Bergareche, A, Arregui, ALD
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19850
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19850
Access Level:acceso abierto
Palabra clave:Endovascular
Nitric Oxide
Endothelium
Age
Arginine
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spelling The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatmentde la Riva, PRodríguez-Antigüedad, JMarta-Enguita, JGómez, VArenaza, GGorostidi, ADíez, Nde Arce, AGarmendia, EZumeta, ELarrea, JABergareche, AArregui, ALDEndovascularNitric OxideEndotheliumAgeArginineBackground: Age is a well-established predictor of poor prognosis in patients with ischemic stroke (IS) undergoing endovascular treatment (EVT). The endothelium plays a central role in the pathophysiology of IS, and its function can be evaluated using various methods. This study aims to investigate the relationship between endothelial dysfunction, age, and clinical outcomes in IS patients treated with EVT Methods: Patients with IS treated with EVT were included in the study. Ninety-day prognosis was evaluated using the modified Rankin Scale (mRS). Endothelial function was assessed through flow-mediated dilation (FMD) measured by brachial artery ultrasound, and by quantifying pre-EVT arterial serum levels of arginine metabolites, homoarginine (hArg), symmetric dimethylarginine (SDMA), and asymmetric dimethylarginine (ADMA), using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Clinical, radiological, and EVT procedural data were recorded as independent variables. The outcome variable is good functional outcome by dichotomized mRS<2. Bivariate, multivariate, and mediation analyses were conducted to explore associations. Results: A total of 150 stroke patients were included in the analysis (median age was 77 years and 50.7 % were female). Older patients exhibited poorer endothelial function, reflected by lower FMD values and altered arginine metabolite profiles. They also showed worse clinical outcomes at 90 days. Among the metabolites, SDMA emerged as an independent predictor of poor prognosis (OR = 1.343 per 0.1 umol/l increase, p < 0.01). Moreover, SDMA was identified as a mediator in the relationship between age and unfavorable outcomes following EVT Conclusion: Endothelial dysfunction, as indicated by circulating biomarkers such as SDMA, may partially mediate the association between age and poorer outcomes in stroke patients treated with EVT.ELSEVIER2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19850Journal of Stroke & Cerebrovascular DiseasesISSN: 10523057ISSNe: 15328511reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p198502026-06-14T12:41:47Z
dc.title.none.fl_str_mv The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
title The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
spellingShingle The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
de la Riva, P
Endovascular
Nitric Oxide
Endothelium
Age
Arginine
title_short The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
title_full The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
title_fullStr The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
title_full_unstemmed The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
title_sort The role of endothelial dysfunction in the age-related poor prognosis of stroke patients undergoing endovascular treatment
dc.creator.none.fl_str_mv de la Riva, P
Rodríguez-Antigüedad, J
Marta-Enguita, J
Gómez, V
Arenaza, G
Gorostidi, A
Díez, N
de Arce, A
Garmendia, E
Zumeta, E
Larrea, JA
Bergareche, A
Arregui, ALD
author de la Riva, P
author_facet de la Riva, P
Rodríguez-Antigüedad, J
Marta-Enguita, J
Gómez, V
Arenaza, G
Gorostidi, A
Díez, N
de Arce, A
Garmendia, E
Zumeta, E
Larrea, JA
Bergareche, A
Arregui, ALD
author_role author
author2 Rodríguez-Antigüedad, J
Marta-Enguita, J
Gómez, V
Arenaza, G
Gorostidi, A
Díez, N
de Arce, A
Garmendia, E
Zumeta, E
Larrea, JA
Bergareche, A
Arregui, ALD
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Endovascular
Nitric Oxide
Endothelium
Age
Arginine
topic Endovascular
Nitric Oxide
Endothelium
Age
Arginine
description Background: Age is a well-established predictor of poor prognosis in patients with ischemic stroke (IS) undergoing endovascular treatment (EVT). The endothelium plays a central role in the pathophysiology of IS, and its function can be evaluated using various methods. This study aims to investigate the relationship between endothelial dysfunction, age, and clinical outcomes in IS patients treated with EVT Methods: Patients with IS treated with EVT were included in the study. Ninety-day prognosis was evaluated using the modified Rankin Scale (mRS). Endothelial function was assessed through flow-mediated dilation (FMD) measured by brachial artery ultrasound, and by quantifying pre-EVT arterial serum levels of arginine metabolites, homoarginine (hArg), symmetric dimethylarginine (SDMA), and asymmetric dimethylarginine (ADMA), using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Clinical, radiological, and EVT procedural data were recorded as independent variables. The outcome variable is good functional outcome by dichotomized mRS<2. Bivariate, multivariate, and mediation analyses were conducted to explore associations. Results: A total of 150 stroke patients were included in the analysis (median age was 77 years and 50.7 % were female). Older patients exhibited poorer endothelial function, reflected by lower FMD values and altered arginine metabolite profiles. They also showed worse clinical outcomes at 90 days. Among the metabolites, SDMA emerged as an independent predictor of poor prognosis (OR = 1.343 per 0.1 umol/l increase, p < 0.01). Moreover, SDMA was identified as a mediator in the relationship between age and unfavorable outcomes following EVT Conclusion: Endothelial dysfunction, as indicated by circulating biomarkers such as SDMA, may partially mediate the association between age and poorer outcomes in stroke patients treated with EVT.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19850
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19850
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER
publisher.none.fl_str_mv ELSEVIER
dc.source.none.fl_str_mv Journal of Stroke & Cerebrovascular Diseases
ISSN: 10523057
ISSNe: 15328511
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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