{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T21:29:06Z","timestamp":1787952546154,"version":"build-2784847793"},"reference-count":53,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leukocyte\u2010driven inflammation may contribute to reperfusion\u2013outcome mismatch after thrombectomy. We tested whether admission white blood cell (WBC) count may identify reperfused patients more likely to benefit from adjunctive methylprednisolone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This post hoc secondary analysis of the MARVEL randomized, placebo\u2010controlled trial was conducted with a prospectively finalized statistical analysis plan. We included patients with anterior\u2010circulation large\u2010vessel occlusion stroke who achieved successful reperfusion after thrombectomy and received intravenous methylprednisolone or placebo. The analysis included 1201 patients stratified by admission WBC count (&lt;\u200910\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009808; \u2265\u200910\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009393). The primary outcome was 90\u2010day modified Rankin Scale (mRS 0\u20136) using covariate\u2010adjusted ordinal logistic regression. Secondary outcomes included mRS 0\u20133 and 0\u20134, early NIHSS, mortality, symptomatic intracranial hemorrhage (sICH), any intracranial hemorrhage, pneumonia, and gastrointestinal bleeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The treatment\u2009\u00d7\u2009WBC interaction reached nominal statistical significance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). In patients with WBC \u2265\u200910\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L, methylprednisolone was associated with a more favorable 90\u2010day ordinal mRS distribution (adjusted common OR, 1.59; 95% CI, 1.11\u20132.28), higher odds of mRS 0\u20133 and 0\u20134, and lower mortality (aOR, 0.60; 95% CI, 0.37\u20130.96) and pneumonia (aOR, 0.61; 95% CI, 0.40\u20130.93), without an apparent increase in hemorrhage or gastrointestinal bleeding. No clear benefit was observed in patients with WBC &lt;\u200910\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher admission WBC was associated with more favorable estimated treatment effects from adjunctive methylprednisolone after thrombectomy, warranting prospective validation.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Chinese Clinical Trial Registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/chictr.org.cn\">ChiCTR.org.cn<\/jats:ext-link>\n                      ); ChiCTR2100051729;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/\">https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.70956","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:05:58Z","timestamp":1780293958000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Adjunctive Methylprednisolone After Thrombectomy: A Secondary Analysis Stratified by Admission White Blood Cell Count"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0703-0224","authenticated-orcid":false,"given":"Chengsong","family":"Yue","sequence":"first","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital Army Medical University (Third Military Medical University)  Chongqing China"},{"name":"Department of Neurology The First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanting","family":"Heng","sequence":"additional","affiliation":[{"name":"Department of Neurology The Second Affiliated Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital Army Medical University (Third Military Medical University)  Chongqing China"},{"name":"Department of Neurology The Second Affiliated Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9628-4938","authenticated-orcid":false,"given":"Shihai","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital Army Medical University (Third Military Medical University)  Chongqing 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