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Higher cystatin C level increases the risk of delayed cerebral ischemia after endovascular treatment of aneurysmal subarachnoid hemorrhage: a case–control study

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Abstract

Cystatin C (CysC) has been found to be associated with hemorrhagic and ischemic stroke in many studies. However, the association between CysC level and the risk of delayed cerebral ischemia after endovascular treatment of aneurysmal subarachnoid hemorrhage has been reported rarely. Our study was proposed to explore this association. Consecutive patients from June 2015 to February 2021 in this single-center retrospective study were selected. Univariate and multivariate analyses were used to identify potential prognostic risk factors for delayed cerebral ischemia, and the stability of the association was demonstrated by several statistical methods, such as subgroup analysis, interaction testing, generalized linear models, and propensity score matching. A total of 424 patients were included in the analysis. Cystatin C was independently associated with delayed cerebral ischemia. The independent effects of CysC on delayed cerebral ischemia were shown in generalized linear models with a logit link, and the results were relatively stable in crude, partial, and full models with ORs (95% CIs) for delayed cerebral ischemia. Subgroup analysis showed no significant subgroup differences in the effect of CysC on delayed cerebral ischemia. There was also no interaction effect between CysC and other confounders. Patients in the high CysC group had a higher risk of delayed cerebral ischemia than those in the low CysC group before and after propensity score matching. CysC level could be an independent predictor for the risk of delayed cerebral ischemia after endovascular treatment of aneurysmal subarachnoid hemorrhage.

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Data availability

After providing a reasonable request, all supporting data for this study are available from the corresponding author.

Code availability

Not applicable.

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Funding

This study was supported by the Special Fund for Science and Technology of Guangdong Province (grant number: [2020]53–50) and the Dengfeng Project for the construction of high-level hospitals in Guangdong Province, The First Affiliated Hospital of Shantou University Medical College Supporting Funding.

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Authors and Affiliations

  1. Department of Neurosurgery, the First Affiliated Hospital of Shantou University Medical College, Shantou, China

    Kehua Chen, Chengwei Cai, Chuangnan Yan, Fuguang Zhang, Junqiang Ma & Hongwu Xu

  2. Shantou University Medical College, Shantou, China

    Kehua Chen, Guanghua Huang, Chengwei Cai, Chuangnan Yan & Fuguang Zhang

  3. Department of Anthropotomy/Clinically Oriented Anatomy, Shantou University Medical College, Shantou, China

    Guanghua Huang & Hongwu Xu

  4. School of Pharmaceutical Sciences, Health Science Centre, Shenzhen University, Shenzhen, China

    Min Yao

  5. Department of Mechanical Engineering, Guangdong Technion-Israel Institute of Technology, Shantou, China

    Thanana Nuchkrua

Authors
  1. Kehua Chen
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  2. Guanghua Huang
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  3. Chengwei Cai
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  4. Chuangnan Yan
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  5. Fuguang Zhang
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  6. Min Yao
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  7. Thanana Nuchkrua
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  8. Junqiang Ma
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  9. Hongwu Xu
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Contributions

Conception and design: Kehua Chen. Acquisition of data: Kehua Chen, Guanghua Huang, Chengwei Cai, Chuangnan Yan, Fuguang Zhang. Statistical analysis: Kehua Chen, Min Yao. Interpretation of data: Kehua Chen, Hongwu Xu. Drafting the article: Kehua Chen. Critically revising the article: Thanana Nuchkrua, Junqiang Ma, Hongwu Xu. Reviewed and approved the submitted version of manuscript: all authors.

Corresponding authors

Correspondence to Junqiang Ma or Hongwu Xu.

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This study has obtained the approval from the institutional review board (grant number: B-2021–231).

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After approval from the institutional review board, informed consent was waived in this retrospective study.

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Chen, K., Huang, G., Cai, C. et al. Higher cystatin C level increases the risk of delayed cerebral ischemia after endovascular treatment of aneurysmal subarachnoid hemorrhage: a case–control study. Neurosurg Rev 45, 2407–2415 (2022). https://doi.org/10.1007/s10143-022-01765-9

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  • DOI: https://doi.org/10.1007/s10143-022-01765-9

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