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dc.contributor.authorBarow, Ewgenia-
dc.contributor.authorQuandt, Fanny-
dc.contributor.authorCheng, Bastian-
dc.contributor.authorGelderblom, Mathias-
dc.contributor.authorJensen, Märit-
dc.contributor.authorKönigsberg, Alina-
dc.contributor.authorBoutitie, Florent-
dc.contributor.authorNighoghossian, Norbert-
dc.contributor.authorEbinger, Martin-
dc.contributor.authorEndres, Matthias-
dc.contributor.authorFiebach, Jochen B-
dc.contributor.authorThijs, Vincent N-
dc.contributor.authorLemmens, Robin-
dc.contributor.authorMuir, Keith W-
dc.contributor.authorPedraza, Salvador-
dc.contributor.authorSimonsen, Claus Z-
dc.contributor.authorGerloff, Christian-
dc.contributor.authorThomalla, Götz-
dc.identifier.citationFrontiers in neurology 2022; 13: 877367en
dc.description.abstractHigher white blood cell (WBC) count is associated with poor functional outcome in acute ischemic stroke (AIS). However, little is known about whether the association is modified by treatment with intravenous alteplase. WAKE-UP was a randomized controlled trial of the efficacy and safety of magnetic resonance imaging [MRI]-based thrombolysis in unknown onset stroke. WBC count was measured on admission and again at 22-36 h after randomization to treatment (follow-up). Favorable outcome was defined by a score of 0 or 1 on the modified Rankin scale (mRS) 90 days after stroke. Further outcome were stroke volume and any hemorrhagic transformation (HT) that were assessed on follow-up CT or MRI. Multiple logistic regression analysis was used to assess the association between outcome and WBC count and treatment group. Of 503 randomized patients, WBC count and baseline parameters were available in 437 patients (μ = 64.7 years, 35.2% women) on admission and 355 patients (μ = 65.1 years, 34.1% women) on follow-up. Median WBC count on admission was 7.6 × 109/L (interquartile range, IQR, 6.1-9.4 × 109/L) and 8.2 × 109/L (IQR, 6.7-9.7 × 109/L) on follow-up. Higher WBC count both on admission and follow-up was associated with lower odds of favorable outcome, adjusted for age, National Institutes of Health (NIH) Stroke Scale Score, temperature, and treatment (alteplase vs. placebo, adjusted odds ratio, aOR 0.85, 95% confidence interval [CI] 0.78-0.94 and aOR 0.88, 95% CI 0.79-0.97). No interaction between WBC count and treatment group was observed (p = 0.11). Furthermore, WBC count on admission and follow-up was significantly associated with HT (aOR 1.14, 95% CI 1.05-1.24 and aOR 1.13, 95% CI 1.00-1.26). Finally, WBC count on follow-up was associated with larger stroke volume (aOR 2.57, 95% CI 1.08-6.07). Higher WBC count is associated with unfavorable outcome, an increased risk of HT, and larger stroke volume, independent of treatment with alteplase. Whether immunomodulatory manipulation of WBC count improves stroke outcome needs to be tested. Identifier: NCT01525290.en
dc.subjectclinical outcomeen
dc.subjectischemic strokeen
dc.subjecttreatment effecten
dc.subjectwhite blood cell count (WBC)en
dc.titleAssociation of White Blood Cell Count With Clinical Outcome Independent of Treatment With Alteplase in Acute Ischemic Stroke.en
dc.typeJournal Articleen
dc.identifier.journaltitleFrontiers in neurologyen
dc.identifier.affiliationKlinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany..en
dc.identifier.affiliationThe Florey Institute of Neuroscience and Mental Healthen
dc.identifier.affiliationHospices Civils de Lyon, Service de Biostatistique, Lyon, France..en
dc.identifier.affiliationDepartment of Stroke Medicine, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France..en
dc.identifier.affiliationCentrum für Schlaganfallforschung Berlin (CSB), Charité-Universitätsmedizin Berlin, Berlin, Germany..en
dc.identifier.affiliationKlinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany..en
dc.identifier.affiliationDepartment of Neurology, University Hospitals Leuven, Leuven, Belgium..en
dc.identifier.affiliationInstitute of Neuroscience & Psychology, University of Glasgow, Glasgow, United Kingdom..en
dc.identifier.affiliationDepartment of Radiology, Institut de Diagnostic per la Image (IDI), Girona, Spain..en
dc.identifier.affiliationDepartment of Neurology, Aarhus University Hospital, Aarhus, Denmark..en
dc.identifier.affiliationUniversité Lyon 1, Villeurbanne, France..en
dc.identifier.affiliationLaboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France..en
dc.identifier.affiliationMedical Park Berlin Humboldtmühle, Klinik für Neurologie, Berlin, Germany..en
dc.identifier.affiliationGerman Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Berlin, Germany..en
dc.identifier.affiliationGerman Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany..en
dc.identifier.affiliationDepartment of Neurosciences, Experimental Neurology, University of Leuven, Leuven, Belgium..en
dc.identifier.affiliationLaboratory of Neurobiology, Center for Brain & Disease Research, Leuven, Belgium..en
dc.identifier.pubmedid35769368, Vincent N
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.languageiso639-1en- Florey Institute of Neuroscience and Mental Health-
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