Association of Alkaline Phosphatase Level with Futile Recanalization in Acute Ischemic Stroke Patients Treated with Endovascular Thrombectomy

Milan Jia ¹, Wantong Yu ¹, Feiyang Jin ¹

⁰Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053, China.

Current Neurovascular Research +

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October 4, 2024

View abstract on PubMed

Summary

Higher serum alkaline phosphatase (ALP) levels at admission predict poor outcomes in Acute Ischemic Stroke (AIS) patients after successful reperfusion therapy. This finding aids in identifying patients at risk for Futile Recanalization (FR).

Area Of Science

Neurology
Biomarkers
Stroke Medicine

Background

Nearly half of Acute Ischemic Stroke (AIS) patients experience unfavorable outcomes despite successful reperfusion, a condition known as Futile Recanalization (FR).
Identifying patients at risk for FR is crucial for optimizing stroke management strategies.
Previous research suggests alkaline phosphatase (ALP) levels may have prognostic value in stroke, but its specific association with FR after thrombectomy was unclear.

Purpose Of The Study

To investigate the association between serum alkaline phosphatase (ALP) levels and Futile Recanalization (FR) in Acute Ischemic Stroke (AIS) patients treated with mechanical thrombectomy.
To determine if serum ALP levels can serve as a predictive biomarker for unfavorable outcomes following successful reperfusion in AIS patients.

Main Methods

Retrospective analysis of 788 AIS patients who underwent thrombectomy between January 2017 and June 2021.
Analysis focused on 277 patients who achieved successful reperfusion (modified Thrombolysis in Cerebral Infarction score=3).
Logistic regression was used to assess the impact of admission serum ALP levels on 3-month unfavorable outcomes (modified Rankin Scale score 3-6), adjusting for confounding variables.

Main Results

Of the 277 successfully reperfused patients, 142 (51.3%) experienced unfavorable outcomes at 3 months.
Higher serum ALP levels at admission were independently associated with unfavorable outcomes (p = 0.002) after adjusting for confounders.
Incorporating ALP levels into conventional risk factor models improved the prediction performance for Futile Recanalization.

Conclusions

Serum ALP levels at admission represent a potential biomarker for predicting Futile Recanalization in AIS patients undergoing thrombectomy.
Elevated ALP may indicate a higher risk of poor outcomes despite successful reperfusion.
Further research is needed to validate the clinical utility of serum ALP for FR prediction in stroke management.

Keywords:

Acute ischemic stroke alkaline phosphatase biomarker futile recanalization stroke prognosis thrombectomy.

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