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. 2022 Sep 20;22(1):359.
doi: 10.1186/s12883-022-02898-6.

Immediate outcome prognostic value of plasma factors in patients with acute ischemic stroke after intravenous thrombolytic treatment

Huanhuan Lu #  1 , Siyi Li #  1 , Xin Zhong #  1 , Shuxuan Huang  1 , Xue Jiao  2 , Guoyong He  1 , Bingjian Jiang  1 , Yuping Liu  1 , Zhili Gao  1 , Jinhong Wei  1 , Yushen Lin  1 , Zhi Chen  3 , Yanhua Li  4
Affiliations

Immediate outcome prognostic value of plasma factors in patients with acute ischemic stroke after intravenous thrombolytic treatment

Huanhuan Lu et al. BMC Neurol. .

Abstract

In the present study, we explored multiple plasma factors to predict the outcomes of patients with AIS after IVT. Fifty AIS patients who received IVT with alteplase were recruited and divided into two groups according to their NIHSS scores. Serum from all subjects was collected to quantitatively analyze the levels of different plasma factors, IL-6, MMP-9, ADAMTS13, TNC, GSN and TRX, using Luminex assays or ELISA measurements. Compared with the levels assessed at the onset of AIS, the levels of MMP-9 (P < 0.001), ADAMTS13 (P < 0.001), and TRX (P < 0.001) significantly decreased after IVT. The level of IL-6 was significantly increased in the NIHSS > 5 group at admission (P < 0.001) compared to the NIHSS ≤ 5 group. AIS patients with a poor prognosis had lower levels of ADAMTS13 at 72 h post-IVT compared with patients with a good prognosis (P = 0.021). IL-6 also was notably higher in the poor outcome group (P = 0.012). After adjusting for confounders, ADAMTS13 at 72 h post-IVT was an independent protective factor for prognosis in AIS patients with an adjusted OR of 0.07 (P = 0.049), whereas IL-6 was an independent predictor of risk for AIS patients with an adjusted OR of 1.152 (P = 0.028). IVT decreased MMP-9, ADAMTS13, and TRX levels in the plasma of AIS patients. Patients with a NIHSS score of less than 5 exhibited lower IL-6 levels, indicating that increased levels of IL-6 correlated with AIS severity after IVT. Therefore, IL-6 and ADAMTS13 might be useful plasma markers to predict the prognosis in AIS patients at 90-days after IVT.

Keywords: Acute ischemic stroke; Intravenous thrombolysis; NIHSS score; Plasma factors; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Changes and intergroup differences in IL-6 (a), MMP-9 (b), TNC (c), ADAMTS13 (d), TRX (e), GSN(f) at different time points after acute ischemic stroke in patients admitted with mild disease and those admitted with reorganized disease.* *p ≤ 0.01,***p ≤ 0.001)
Fig. 2
Fig. 2
The relationship between IL-6, ADAMTS13 and AIS outcomes 72 h after IVT. The concentration of ADAMTS13 were decreased in the unfavorable outcome group. However, the levels of IL-6 were significantly increased in the poor outcome group compared with the favorable outcome group. Data are presented as mean ± SEM, *p < 0.05
Fig. 3
Fig. 3
ROC curve of 90-day prognosis predicted by IL-6 and ADAMTS13 at 72 h after acute ischemic stroke onset. The optimal cutoff value of IL-6 was 5.795 pg/ml with a sensitivity of 66.7% and a specificity of 72.4% (AUC: 0.71, 95% CI (0.566–0.854; P = 0.012)
See this image and copyright information in PMC

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