Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China.
Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China.
Nutr Metab Cardiovasc Dis. 2022 Jan;32(1):195-202. doi: 10.1016/j.numecd.2021.09.030. Epub 2021 Oct 9.
To investigate the relationship between chromogranin A (CgA) levels and acute ischemic stroke (AIS), especially anterior circulation large vessel occlusion (LVO).
587 subjects were included in this study, including 205 AIS patients with anterior circulation LVO and 205 nonocclusive patients, as well as 177 healthy controls. On admission, plasma CgA levels were measured and neurological deficits were assessed by the NIH Stroke Scale. Outcomes were assessed by the modified Rankin Scale at 3 months. The predictive properties of CgA were evaluated by receiver operating characteristic (ROC) curve analysis. Binary logistic analysis assessed the association of CgA levels and AIS or anterior circulation LVO. AIS patients had lower CgA levels than health controls (p < 0.001). Anterior circulation LVO patients had lower CgA levels than nonocclusive patients (p < 0.001). The area under the ROC curve of plasma CgA levels in predicting anterior circulation LVO from AIS was 0.744 and the optimal cutoff value was 15.49 ng/mL with a Youden value of 0.332. Logistic analysis showed that CgA ≤15.49 ng/mL remained an independent risk factor for anterior circulation LVO after adjusting for related factors (OR = 6.519, 95% CI: 3.790-11.214, p < 0.001). CgA was an independent protective factor for mild stroke and good prognosis (p = 0.009, p = 0.005); however, the association disappeared after adjusting for occlusion (p = 0.768, p = 0.335).
CgA levels were lower in AIS patients, especially in anterior circulation LVO patients. Lower CgA levels are potential biomarker for anterior circulation LVO, and they may indicate good prognosis at 3 months in AIS.
研究嗜铬粒蛋白 A(CgA)水平与急性缺血性脑卒中(AIS),尤其是前循环大血管闭塞(LVO)的关系。
本研究纳入 587 例患者,其中 205 例为前循环 LVO 急性脑梗死患者,205 例为非闭塞性患者,177 例为健康对照者。入院时,测量患者的血浆 CgA 水平,并采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能缺损程度。采用改良 Rankin 量表(mRS)在 3 个月时评估预后。通过受试者工作特征(ROC)曲线分析评估 CgA 的预测性能。二元逻辑分析评估 CgA 水平与 AIS 或前循环 LVO 的相关性。AIS 患者的 CgA 水平低于健康对照组(p<0.001)。前循环 LVO 患者的 CgA 水平低于非闭塞性患者(p<0.001)。预测 AIS 患者前循环 LVO 时,血浆 CgA 水平的 ROC 曲线下面积为 0.744,最佳截断值为 15.49ng/ml,Youden 值为 0.332。Logistic 分析显示,在校正相关因素后,CgA≤15.49ng/ml 仍然是前循环 LVO 的独立危险因素(OR=6.519,95%CI:3.790-11.214,p<0.001)。CgA 是轻度卒中及良好预后的独立保护因素(p=0.009,p=0.005);然而,在校正闭塞后,这种相关性消失(p=0.768,p=0.335)。
AIS 患者,尤其是前循环 LVO 患者的 CgA 水平较低。较低的 CgA 水平可能是前循环 LVO 的潜在生物标志物,提示 AIS 患者 3 个月时预后良好。