title: Laboratory-Based Markers as Predictors of Brain Infarction During Carotid Stenting: a Prospective Study.
abstract: OBJECTIVE
  New ischemic lesions in the brain can be detected in approximately 50% of patients undergoing carotid artery stenting (CAS). We wished to discover the laboratory-based predictors of new infarctions in the brain after CAS.
  
  
  METHODS
  All consecutive patients with internal carotid artery stenosis of ≥70% with indication for CAS were enrolled in a prospective study for 16 months. All patients used dual antiplatelet therapy for ≥7 days before CAS. Neurologic examination and magnetic resonance imaging (MRI) of the brain were undertaken before and at 24 h after CAS. Samples of venous blood were collected at ＜24 h before CAS for the evaluation of hematology, reticulocytes, coagulation markers (PT, APTT, Fbg, Clauss), vWF antigen, PAI-1 activity, PAI-1 polymorphism 4G/5G, and the multiplate (aspirin and clopidogrel) resistance test. Blood samples for the assessment of anti-Xa activity were collected during CAS. Differences in the values of laboratory markers between patients with and without new ischemic lesions of the brain on control MRI were evaluated.
  
  
  RESULTS
  The cohort comprised 81 patients (53 males; mean age, 67.3±7.2 years). New ischemic infarctions in the brain on control MRI were found in 46 (56.8%) patients. Three of seven patients with resistance to aspirin or clopidogrel had a new ischemic infarction in the brain. No significant differences for particular markers were found between patients with and without an ischemic lesion in the brain.
  
  
  CONCLUSIONS
  A high risk of a new ischemic infarction in the brain was detected in patients undergoing CAS, but a laboratory-based predictor of such an infarction could not be identified.
authors.affiliation: Department of Neurology, Comprehensive Stroke Center, University Hospital Ostrava.
authors.forename: Martin
authors.initials: M
authors.lastname: Kuliha
authors.forename: Martin
authors.initials: M
authors.lastname: Roubec
authors.forename: Andrea
authors.initials: A
authors.lastname: Goldírová
authors.forename: Eva
authors.initials: E
authors.lastname: Hurtíková
authors.forename: Tomáš
authors.initials: T
authors.lastname: Jonszta
authors.forename: Václav
authors.initials: V
authors.lastname: Procházka
authors.forename: Jaromír
authors.initials: J
authors.lastname: Gumulec
authors.forename: Roman
authors.initials: R
authors.lastname: Herzig
authors.forename: David
authors.initials: D
authors.lastname: Školoudík
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis*; D020520:Brain Infarction / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D016893:Carotid Stenosis / Q000150:complications* / Q000601:surgery; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers