With great interest, we read the recent original article written by Zihan Chang et al¹, which was published in European Journal of Neurology. In this multicenter retrospective case‐control study, the authors found that elevated serum Cystatin C may be associated with unfavorable clinical outcomes after intravenous tissue plasminogen activator therapy, independently. The results of receiver operating characteristic curves also showed that model 1 (combining baseline Cystatin C, hypertension, early infarct signs on admission CT scan, WBC and smoking) was able to predict good&sustained benefit (Area under the curve is 0.75). What is more, model 2 (combining baseline Cystatin C, NIHSS on admission, hypertension, early infarct signs on admission CT, and TOAST subtype large‐artery atherosclerosis) can be used to forecast good functional outcome (Area under the curve is 0.86). Nevertheless, I still have comments.

中文翻译：

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胱抑素 C 和静脉溶栓

怀着极大的兴趣，我们阅读了最近发表在《欧洲神经病学杂志》上的张子涵等人^{1 的}原创文章. 在这项多中心回顾性病例对照研究中，作者发现血清胱抑素 C 升高可能独立地与静脉组织纤溶酶原激活剂治疗后不利的临床结果相关。受试者工作特征曲线的结果还表明，模型 1（结合基线胱抑素 C、高血压、入院 CT 扫描早期梗死征象、WBC 和吸烟）能够预测良好且持续的获益（曲线下面积为 0.75）。此外，模型 2（结合基线胱抑素 C、入院时 NIHSS、高血压、入院 CT 早期梗死征象和 TOAST 亚型大动脉粥样硬化）可用于预测良好的功能结果（曲线下面积为 0.86）。尽管如此，我仍然有意见。