Department of Neurology, Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Cerebrovasc Dis Extra. 2023;13(1):33-40. doi: 10.1159/000529512. Epub 2023 Feb 8.
There are very limited data on the role of biomarkers correlating with the outcome in acute ischemic stroke (AIS). We evaluated the predictive values of the plasma concentrations of soluble serum stimulation-2 (sST2), matrix metalloproteinase-9 (MMP-9), and claudin-5 in AIS.
The biomarker levels in the plasma samples of consecutive AIS patients collected at baseline, 12 h, and 24 h from stroke onset were quantified using immunoassays. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and functional outcome at 90 days using the modified Rankin Scale (mRS), with scores above 3 defined as poor outcome. Receiver operating characteristic curve analysis and multiple logistic regression were performed for evaluating the discriminative power of each marker.
We included 108 patients in the study (mean age 62.3 ± 11.7 years). Median NIHSS score was 12 (interquartile range 8-18). High baseline glucose levels, systolic blood pressure, baseline NIHSS, low Alberta Stroke Program Early CT Score, and hemorrhagic transformation were associated with poor outcomes. Elevated sST2 at 12 h (50.4 ± 51.0 ng/mL; p = 0.047) and 24 h (81.8 ± 101.3 ng/mL; p = 0.001) positively correlated with poor outcomes. MMP-9 (p = 0.086) and claudin-5 (p = 0.2) were not significantly associated with the outcome, although increased expressions of both markers were observed at 12 h. Multiple logistic regression showed that sST2 levels ≥71.8 ng/mL at 24 h, with a specificity of 96.9%, emerged as an independent predictor of poor functional outcome (OR: 6.44; 95% CI: 1.40-46.3; p = 0.029).
Evaluation of sST2 may act as a reliable biomarker of functional outcome in AIS.
关于与急性缺血性脑卒中（AIS）结局相关的生物标志物的作用，目前数据非常有限。我们评估了血浆可溶性血清刺激-2（sST2）、基质金属蛋白酶-9（MMP-9）和紧密连接蛋白-5 浓度在 AIS 中的预测价值。
采用免疫分析法定量检测连续采集的 AIS 患者发病后基线、12 小时和 24 小时的血浆样本中的生物标志物水平。采用国立卫生研究院卒中量表（NIHSS）评估卒中严重程度，采用改良 Rankin 量表（mRS）评估 90 天的功能结局，评分＞3 定义为不良结局。采用受试者工作特征曲线分析和多因素逻辑回归评估每个标志物的判别能力。
我们纳入了 108 例患者（平均年龄 62.3±11.7 岁）。中位 NIHSS 评分为 12（四分位距 8-18）。基线高血糖水平、收缩压、基线 NIHSS、低阿尔伯塔卒中项目早期 CT 评分和出血性转化与不良结局相关。12 小时（50.4±51.0ng/mL；p=0.047）和 24 小时（81.8±101.3ng/mL；p=0.001）sST2 水平升高与不良结局呈正相关。MMP-9（p=0.086）和紧密连接蛋白-5（p=0.2）与结局无显著相关性，尽管两种标志物的表达在 12 小时均升高。多因素逻辑回归显示，24 小时 sST2 水平≥71.8ng/mL，特异性为 96.9%，是不良功能结局的独立预测因子（OR：6.44；95%CI：1.40-46.3；p=0.029）。
sST2 的评估可能是 AIS 功能结局的可靠生物标志物。
