Stroke is defined as an acute neurological deficit with cardiovascular aetiology lasting over 24 hours. This is the second leading cause of death in middle- to higher-income countries, and the leading cause of neurological disability in adults in Ireland; additionally, the number of admissions for stroke to Irish hospitals is increasing each year. (1) Stroke pathogenesis can be divided into haemorrhagic or ischaemic, of which ischaemic – in which narrowing/occlusion of a vessel occurs – is the more common. Treatment of stroke aims at acute reperfusion of the ischaemic penumbra of tissue, through thrombolysis (intravenous alteplase or tenecteplase) and/or endovascular thrombectomy. Swift recanalization is vital to preserving neurological function, minimizing recovery time and ultimately maximizing quality of life for patients post-acutely. (2) This project will draw on the ‘RESTORE’ registry, led by Prof. Doyle, which has collected over 1,000 acute ischaemic stroke (AIS) clots. As part of collaborative efforts between stroke centres across Europe, thrombi extracted from ischaemic stroke victims can be analysed using histology and immunohistochemistry, to identify clots associated with C-reactive protein (CRP) or interleukin-6 (IL6), markers of inflammation. Inflammation has been shown to influence formation of thrombi, particularly cardioembolic clots or large artery atherosclerosis clots. CRP and IL-6 have also been associated with vascular recurrence after stroke. (4, 5) This project will analyse CRP and IL-6 in AIS clots with respect to aetiology and patient outcome measures e.g. the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and modified Treatment In Cerebral Infarction (mTICI) scale. Any correlations or associations elucidated between elements composing the clots with outcomes could provide direction to ultimately reduce the neurological deficit, shorten the recovery times, and improve the quality of life of ischaemic stroke victims.
