To establish serum concentration of protein S100B as an objective biomarker surrogate for astroglial tissue damage after mechanical thrombectomy in patients with acute ischemic stroke.

This prospective 2-center study recruited patients with acute middle cerebral artery infarctions caused by large vessel occlusion treated with mechanical thrombectomy. Blood samples were collected at day 2 after intervention and analyzed for S100B serum concentrations using ELISA techniques. Infarct size was determined on follow-up brain imaging and functional outcome according to modified Rankin Scale (mRS) was assessed at 90 days.

A total of 171 patients were included (mean age ± SD: 70 ± 14 years, 42% female). S100B levels correlated with infarct size. Median S100B concentrations at day 2 after intervention were lower in patients with favorable outcome (mRS score 0–1) at 90 days compared to patients with unfavorable outcome (mRS score 2–6) (median 0.10 µg/L [interquartile range 0.07–0.14] vs 0.20 µg/L [0.11–0.48], p < 0.001). Younger age (odds ratio [OR] 1.120 [confidence interval (CI) 1.068–1.174]; p < 0.001), lower National Institutes of Health Stroke Scale score 24 hours after symptom onset (OR 1.232 [CI 1.106–1.372]; p < 0.001), and lower S100B serum concentrations (OR 1.364 [CI 1.105–1.683]; p = 0.004) were independently associated with a favorable outcome. S100B was able to eliminate the lateralization bias associated with the use of mRS for functional outcome assessment at 90 days after stroke.

S100B serum concentrations after mechanical thrombectomy indicate the extent of ischemic tissue damage. This can be assessed rapidly, independent of brain imaging and clinical outcome scales. Following prospective validation in further studies, this may provide an objective surrogate outcome measure both in clinical routine and interventional trials.

This study provides Class I evidence that S100B 2 days following mechanical thrombectomy for acute ischemic stroke accurately distinguishes favorable from unfavorable functional outcome.

建立血清 S100B 蛋白浓度作为急性缺血性卒中患者机械取栓后星形胶质细胞组织损伤的客观生物标志物替代物。

这项前瞻性 2 中心研究招募了接受机械取栓治疗的大血管闭塞引起的急性大脑中动脉梗死患者。在干预后第 2 天收集血样，并使用 ELISA 技术分析 S100B 血清浓度。在 90 天时，根据改良 Rankin 量表 (mRS) 评估随访脑成像和功能结果，确定梗死面积。

共纳入 171 名患者（平均年龄 ± SD：70 ± 14 岁，42% 为女性）。S100B 水平与梗死面积相关。与预后不良（mRS 评分 2-6）的患者相比，干预后第 2 天的中位 S100B 浓度在 90 天时较低（中位数为 0.10 µg/L [四分位距 0.07-0.14） ] 与 0.20 µg/L [0.11–0.48]，p < 0.001)。年龄较小（优势比 [OR] 1.120 [置信区间 (CI) 1.068–1.174]；p < 0.001），症状发作 24 小时后美国国立卫生研究院卒中量表评分较低（OR 1.232 [CI 1.106–1.372]；p < 0.001）和较低的 S100B 血清浓度（OR 1.364 [CI 1.105–1.683]；p= 0.004）与良好的结果独立相关。S100B 能够消除与使用 mRS 在中风后 90 天进行功能结果评估相关的偏侧偏倚。

机械取栓后的 S100B 血清浓度表明缺血性组织损伤的程度。这可以快速评估，独立于脑成像和临床结果量表。在进一步研究中进行前瞻性验证后，这可能会在临床常规和介入试验中提供客观的替代结果测量。

这项研究提供了 I 类证据，表明急性缺血性卒中机械取栓后 2 天的 S100B 准确地区分了有利和不利的功能结果。