Predictive value of serum biomarkers for cerebral edema and prognosis after endovascular thrombectomy in patients with acute ischemic stroke and large vessel occlusion in the anterior circulation
WANG Qibai
CHENG Denggui
Abstract：Objective To investigate the predictive value of serum biomarkers for cerebral edema and prognosis after endovascular thrombectomy(EVT)in patients with acute ischemic stroke and large vessel occlusion(AIS-LVO)in the anterior circulation.Methods A total of 108 patients with anterior circulation AIS-LVO were selected and divided into a mild group(n=42),a moderate group(n=31),and a severe group(n=35)according to the severity of cerebral edema.An ordinal multinomial logistic regression model was used to analyze the influencing factors of the severity of cerebral edema in patients with anterior circulation AIS-LVO.The severity of cerebral edema and prognosis were compared among patients with different levels of nuclear factor erythroid 2-related factor 2(Nrf2)and heme oxygenase-1(HO-1).Results There were significant differences in the serum levels of Nrf2 and HO-1 among the three groups(all P<0.05).As the severity of cerebral edema increased,the serum levels of Nrf2 and HO-1 decreased.Hypertension and a high National Institutes of Health Stroke Scale(NIHSS)score at admission were independent risk factors for the severity of cerebral edema after EVT in patients with anterior circulation AIS-LVO.Vascular recanalization,Nrf2,and HO-1 were associated with reduced severity of cerebral edema after EVT in AIS-LVO patients(all P<0.05).The likelihood ratio test results indicated that the model fit was statistically significant(χ2=81.629,P<0.01).There were significant differences in the severity of cerebral edema and prognosis among patients with different levels of Nrf2 and HO-1(all P<0.05).In patients with anterior circulation AIS-LVO,lower levels of Nrf2 and HO-1 were associated with more severe cerebral edema and a higher risk of poor prognosis.The combined predictive ability of serum Nrf2 and HO-1 levels for the prognosis of AIS-LVO patients was reflected by an area under the curve(AUC)value of 0.854,which was greater than the prediction made by either serum Nrf2(Z=2.146,P=0.032)or HO-1(Z=2.323,P=0.020)levels alone.Conclusions Decreased serum levels of Nrf2 and HO-1 are associated with increased severity of cerebral edema and poor prognosis in patients with anterior circulation AIS-LVO.They are protective factors for cerebral edema,and combined detection has a higher predictive value for prognosis.
Keywords：strokeischemicacuteanterior circulationlarge vessel occlusionnuclear factor erythroid 2-related factor 2heme oxygenase-1cerebral edema
Publication Date：2026-02-20
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：7( 102-108 )