Baseline severity and soluble vascular cell adhesion molecule 1 (sVCAM-1) as biomarker predictors of short-term mortality in acute ischemic stroke.

Autor: de Araújo MCM; Clinical and Laboratory Pathophysiology Postgraduate Program, Health Sciences Center, State University of Londrina, Paraná, Brazil., Alfieri DF; Department of Pharmaceutical Sciences, Health Sciences Center, State University of Londrina, Paraná, Brazil., Lehmann ALCF; Department of Clinical Medicine, Health Science Center and Radiology Service of the University Hospital, State University of Londrina, Paraná, Brazil., Luz TF; Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Paraná, Brazil., Trevisani ER; Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Paraná, Brazil., Nagao MR; Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Paraná, Brazil., de Freitas LB; Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Paraná, Brazil., Simão ANC; Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Paraná, Brazil.; Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, Londrina, Paraná, CEP 86.038-440, Brazil., Reiche EMV; Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Paraná, Brazil. reiche@sercomtel.com.br.; Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, Londrina, Paraná, CEP 86.038-440, Brazil. reiche@sercomtel.com.br.
Jazyk: angličtina
Zdroj: Metabolic brain disease [Metab Brain Dis] 2023 Feb; Vol. 38 (2), pp. 657-670. Date of Electronic Publication: 2022 Nov 21.
DOI: 10.1007/s11011-022-01116-z
Abstrakt: The aim was to investigate the association between plasma levels of cellular adhesion molecules (CAMs) and risk factors, subtypes, severity and short-term mortality of acute ischemic stroke (IS), and to identify a panel of biomarkers to predict short-term mortality after IS. The prospective study evaluated 132 IS patients within 24 h of their hospital admission. The baseline IS severity was assessed using the National Institutes Health Stroke Scale (NIHSS) and categorized as mild (NIHSS < 5), moderate (NIHSS 5-14) and severe (NIHSS ≥ 15). After three-month follow-up, the disability was assessed using the modified Rankin Scale (mRS); moreover, the patients were classified as survivors and non-survivors. Baseline inflammatory and anti-inflammatory cytokines and soluble CAMs were evaluated. Twenty-nine (21.9%) IS patients were non-survivors and showed higher NIHSS and soluble vascular cellular adhesion molecule 1 (sVCAM-1) than the survivors. The sVCAM-1 levels positively correlated with age, homocysteine, severity, and disability. The model #3 combining sVCAM-1 and NIHSS showed better results to predict short-term mortality with an area under the curve receiving operating characteristics (AUC/ROC) of 0.8841 [95% confidence interval (CI): 0.795-0.941] than the models with sVCAM-1 and NIHSS alone, with positive predictive value of 68.0%, negative predictive value of 91.3%, and accuracy of 86.5%. In conclusion, the combined model with baseline severity of IS and sVCAM-1 levels can early predict the prognosis of IS patients who may benefit with therapeutic measures of personalized therapy that taken into account these biomarkers. Moreover, this result suggests that VCAM-1 might be a potential target for the therapeutic strategies in IS.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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