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Genotype Tied to Endovascular Therapy Outcomes in LVO Stroke

Instant, early reocclusion more frequent in carriers of the RNF213 p.R4810K variant, found mainly in people of East Asian descent

TUESDAY, July 19, 2022 (HealthDay News) — Carriers of the ring finger protein 213 p.R4810K variant who undergo endovascular therapy for acute anterior-circulation large-vessel occlusion more often have instant and early reocclusion, according to a study published online July 12 in Stroke: Vascular and Interventional Neurology.

Takeshi Yoshimoto, M.D., from Hiroshima University in Japan, and colleagues examined the impact of the ring finger protein 213 p.R4810K variant on endovascular therapy outcomes in patients with acute anterior-circulation large-vessel occlusion stroke. A total of 277 participants who underwent endovascular therapy for acute occlusion of the intracranial internal carotid artery or M1 segment of the middle cerebral artery were included; 10 (3.6 percent) harbored the ring finger protein 213 p.R4810K variant.

The researchers found that compared with noncarriers, carriers were younger and more often had intracranial atherosclerotic disease-related large-vessel occlusion as a cause of acute large-vessel occlusion. A higher rate of instant reocclusion was seen for variant carriers versus noncarriers (70.0 versus 5.6 percent), but no significant intergroup differences were seen in the final modified Thrombolysis in Cerebral Infarction ≥2b reperfusion rate. Compared with noncarriers, carriers more often had early reocclusion (60.0 versus 0.4 percent).

“In the field of acute stroke, genetic testing has not been considered important,” a coauthor said in a statement. “However, since our study found that a specific genetic variant substantially affects the outcome of endovascular therapy, physicians involved in acute stroke medicine, especially in East Asian countries and in western countries where many East Asian descendants are living, need to know these findings.”

Several authors disclosed financial ties to the pharmaceutical industry.

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