Objective: This study aimed to evaluate the utility of the CHA2DS2-VASc score for predicting futile recanalization among patients with acute ischemic stroke (AIS) who underwent endovascular treatment (EVT). Methods: A total of 97 AIS patients who achieved complete or near-complete recanalization after EVT were included in our study. Clinical, angiographic, and laboratory data were analyzed retrospectively. Using the modified Rankin Scale (mRS) at 90 days after the intervention, the patients were divided into two groups, the futile recanalization group (mRS ≥3) and the favorable recanalization group (mRS ≤2). The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of the CHA2DS2-VASc score for predicting futile recanalization.Multivariate stepwise logistic regression analysis analyzed the association between the CHA2DS2-VASc score and futile recanalization risk after EVT. Results: The CHA2DS2-VASc score was significantly higher in patients with futile recanalization compared to patients with favorable recanalization [4 (3-6) vs. 3 (1-4), p=0.002]. A ROC curve analysis revealed that the cut-off value of CHA2DS2-VASc score for predicting futile recanalization was >3, with sensitivity and specificity of 65% and 72%, respectively (Area under curve (AUC), 0.697; 95% Confidence interval (CI):0.580-0.814). In multivariate analysis;the CHA2DS2- VASc score (Odds ratio (OR)=1.637, 95% CI:1.181-2.334, p=0.004) and baseline National Institutes of Health Stroke Scale score (OR=1.217, 95% CI:0.985-1.503, p=0.039) were found independent predictors for futile recanalization after EVT. Conclusion: The CHA2DS2-VASc score can be used as a simple and effective tool to predict futile recanalization in patients with AIS.
Introduction.It is known that multiple sclerosis (MS) often coexists with other autoimmune diseases. Hence, autoantibody (auto-Ab) tests may prove useful in the differential diagnosis of MS. The objectives of this study were to: (a) investigate the prevalence of auto-Ab positivity at the beginning of the MS diagnostic process; (b) assess whether Auto-Ab+ and Auto-Ab-patients differ in baseline clinical, laboratory, and radiological parameters; and (c) investigate the prognostic value during a two-year follow-up period.Material and methods. This retrospective study consisted of 450 patients aged between 18 and 55 years. All patients underwent a wide range of auto-Ab tests, anti-nuclear antibody (ANA) tests in particular. The expanded disability status scale (EDSS) scores of the patients were recorded at the time of diagnosis and at the end of a two-year follow-up period.Results. The mean age of the 212 patients, 148 (69.8%) female and 64 (30.2%) male, included in the study sample was 37 ± 10.83 years. The rate of relapsing cases was 84% (178). Oligoclonal band (OCB) was positive in 142 (86.6%) of the 164 tested cases. At least one of the auto-Ab tests was positive in 51 (24.1%) of the cases. ANA test was positive in 21 (9.9%) cases. There was no significant difference between patients with at least one positive auto-Ab test and without any positive auto-Ab test and between ANA-positive and ANA-negative patients in terms of age, gender, clinical features of MS, presence of brain stem lesion, presence of spinal lesion, OCB positivity, level of clinical improvement after the first pulse steroid treatment, family history, presence of comorbidity, presence of autoimmune disease, or EDSS scores recorded at the end of the two-year follow-up period (p > 0.05). Conclusions.Our study findings revealed that Auto-Ab positivity was more common in MS patients than in the general population. However, given their limited contribution to the diagnosis and differential diagnosis of MS with no effect on the prognostic process, auto-Ab tests should be requested only in the event of accompanying autoimmune disease symptoms, and in cases where the diagnosis of MS may be suspected.
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