Department of Neurology, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
Divisions of Stroke, Cerebrovascular and Critical Care Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Int J Stroke. 2021 Aug;16(6):660-668. doi: 10.1177/1747493020971166. Epub 2020 Nov 9.
Time-dependent change in the level of biomarkers after stroke is not well understood. We sought to compare fatty acid-binding protein 4 (FABP4), Galectin-3, and soluble ST2 to ascertain for a change in prediction of outcome at admission and 48 h later.
Plasma FABP4, Galectin-3, and soluble ST2 were measured in biospecimens from acute stroke patients at the time of admission ( = 383) and 48 h later ( = 244). Functional outcome was assessed at 90 days using the modified Rankin Scale and dichotomized into good (modified Rankin Scale 0-2) and poor outcome (modified Rankin Scale 3-6).
On admission, elevated levels of each biomarker predicted poor outcome (FABP4: OR 1.92, 95% CI 1.42-2.59, < 0.0001; Galectin-3: OR 1.85, 95% CI 1.42-2.40, < 0.0001; soluble ST2: OR 1.55, 95% CI 1.22-1.97, < 0.0001) and death (FABP4: OR 2.45; 95% CI 1.51-3.98; < 0.0001; Galectin-3: OR 2.12; 95% CI 1.50-3.30; < 0.0001; soluble ST2: OR 2.17; 95% CI 1.58-2.99; < 0.0001). At 48 h, soluble ST2 predicted poor outcome (OR 2.62, 95% CI 1.77-3.88, < 0.0001) and mortality (OR 3.36, 95% CI 2.06-5.48, < 0.0001), and Galectin-3 predicted mortality only (OR 1.81, 95% CI 1.05-3.10, = 0.033). FABP4 measured at 48 h was not predictive of outcome or death. Associations of Galectin-3 and soluble ST2 with outcome or mortality were independent of age, sex, and NIHSS, whereas those with FABP4 were not.
Galectin-3 performed better when measured on admission, whereas soluble ST2 was predictive at admission and better at 48 h after stroke. The time-dependent differences may reflect the evolving role of these pathways after acute stroke.
目前对于卒中后生物标志物水平的时间依赖性变化尚不清楚。我们旨在比较脂肪酸结合蛋白 4（FABP4）、半乳糖凝集素 3（Galectin-3）和可溶性 ST2，以确定它们在入院时和入院后 48 小时预测预后的变化。
在急性卒中患者的生物标本中检测入院时（n=383）和入院后 48 小时（n=244）的 FABP4、Galectin-3 和可溶性 ST2 水平。使用改良 Rankin 量表（mRS）在 90 天评估功能结局，并将其分为良好结局（mRS 0-2）和不良结局（mRS 3-6）。
入院时，每种生物标志物水平升高均预测不良结局（FABP4：比值比 1.92，95%置信区间 1.42-2.59，<0.0001；Galectin-3：比值比 1.85，95%置信区间 1.42-2.40，<0.0001；可溶性 ST2：比值比 1.55，95%置信区间 1.22-1.97，<0.0001）和死亡（FABP4：比值比 2.45；95%置信区间 1.51-3.98；<0.0001；Galectin-3：比值比 2.12；95%置信区间 1.50-3.30；<0.0001；可溶性 ST2：比值比 2.17；95%置信区间 1.58-2.99；<0.0001）。入院后 48 小时，可溶性 ST2 预测不良结局（比值比 2.62，95%置信区间 1.77-3.88，<0.0001）和死亡率（比值比 3.36，95%置信区间 2.06-5.48，<0.0001），Galectin-3 仅预测死亡率（比值比 1.81，95%置信区间 1.05-3.10，=0.033）。入院时 FABP4 水平与结局或死亡率无关。Galectin-3 和可溶性 ST2 与结局或死亡率的相关性独立于年龄、性别和 NIHSS，而 FABP4 则不然。
Galectin-3 在入院时检测结果更好，而可溶性 ST2 在入院时和卒中后 48 小时预测结果更好。这些时间依赖性差异可能反映了这些通路在急性卒中后的作用演变。
