Examinando por Autor "Marta Enguita, Juan"

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  • Miniatura
    Ítem
    Systemic inflammation and endothelial dysfunction influence the risk and severity of hemorrhagic transformation after endovascular treatment for acute ischemic stroke
    (Frontiers Media SA, 2026) Álvarez Agoués, Kattalin; Riva Juez, Patricia de la ; Rodríguez-Antigüedad Muñoz, Jon; Gómez, Virginia; Arenaza Choperena, Gorka ; Gorostidi, Ana; Díez, Noemí; Arce Borda, Ana de ; Martínez Zabaleta, María Teresa ; Garmendia, Eñaut; Lüttich, Alex; Anabitarte González, Maier ; Larrea Peña, José Ángel; Bergareche, A; López de Munain Arregui, Adolfo ; Marta Enguita, Juan
    Background – Hemorrhagic transformation (HT) is a frequent and serious complication, occurring in up to 40% of cases after endovascular treatment (EVT) for acute ischemic stroke (AIS). Inflammation has been increasingly recognized as a key factor influencing both stroke pathophysiology and post-treatment complications (such as HT) interacting with endothelial dysfunction to exacerbate vascular injury after EVT. The objective of this study is to evaluate whether systemic inflammatory status predicts HT in AIS patients, and its relationship with endothelial biomarkers in the setting of this complication. Methods – We retrospectively reviewed a prospective cohort of 229 AIS patients treated with EVT. Demographic, clinical, imaging, and laboratory data were collected. Inflammatory markers included white blood cell subsets and indices such as neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). Endothelial function was assessed by flow-mediated dilation (FMD) and circulating homoarginine (HArg), asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA). The main outcome was radiological or symptomatic HT, classified according to ECASS criteria. Results – HT was observed in 92 patients (40.2%), of whom 35 (36.1% of HT and 15.3% of the total) were symptomatic. In multivariate analysis, independent predictors of HT included higher NIHSS at admission, higher plasma glucose at admission, the use of non-aspiration devices, lower pre-recanalization lymphocyte count, higher pre-recanalization SII and higher NLR levels. Among endothelial function markers, HArg correlated with inflammatory markers, ANC (r = −0.2) and WBC (r = −0.19), and was associated to PH and symptomatic HT, but not with any radiologic HT after AIS. Conclusion – An altered inflammatory status prior to EVT in AIS patients is associated with an increased risk of developing HT after EVT. Additionally, endothelial dysfunction could participate in the more aggressive forms of this complication.
  • Miniatura
    Ítem
    Understanding endothelial dysfunction and its role in ischemic stroke after the outbreak of recanalization therapies
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024-10-29) Riva Juez, Patricia de la; Marta Enguita, Juan; Rodríguez-Antigüedad Muñoz, Jon; Bergareche, Alberto; López de Munain Arregui, Adolfo
    Despite recent advances in treatment options, stroke remains a highly prevalent and devastating condition with significant socioeconomic impact. Recanalization therapies, including intravenous thrombolysis and endovascular treatments, have revolutionized stroke management and prognosis, providing a promising framework for exploring new therapeutic strategies. Endothelial dysfunction plays a critical role in the pathophysiology, progression, and prognosis of stroke. This review aims to synthesize the current evidence regarding the involvement of the nitric oxide (NO)/endothelium pathway in ischemic stroke, with a particular focus on aging, response to recanalization therapies, and therapeutic approaches. While significant progress has been made in recent years in understanding the relationship between endothelial dysfunction and stroke, many uncertainties persist, and although treatments targeting this pathway are promising, they have yet to demonstrate clear clinical benefits.