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. 2024 Jan 12;46(1):677-688.
doi: 10.3390/cimb46010044.

Thrombomodulin Serum Levels-A Predictable Biomarker for the Acute Onset of Ischemic Stroke

Andrei-Lucian Zaharia  1   2 , Dana Tutunaru  1   2 , Violeta Diana Oprea  1   2 , Claudiu Elisei Tănase  2   3 , Ana Croitoru  1   2 , Bianca Stan  1   2 , Doina Carina Voinescu  1   2 , Ana-Maria Ionescu  4 , Camelia Alexandra Coadǎ  5 , Mihaiela Lungu  1   2
Affiliations

Thrombomodulin Serum Levels-A Predictable Biomarker for the Acute Onset of Ischemic Stroke

Andrei-Lucian Zaharia et al. Curr Issues Mol Biol. .

Abstract

The early diagnosis of acute ischemic stroke (AIS) can be challenging in cases presenting with a scarcity of clinical signs, normal cerebral imaging in early stages and a lack of specific serum markers. Thrombomodulin has been shown to be associated with cerebrovascular ischemic events and can be considered an important biomarker for the acute onset of ischemic stroke. In our study, we compared the serum levels of thrombomodulin (sTM) between a relevant patient group of 70 AIS patients and a control group of patients without AIS admitted into the neurology department between June 2022 and May 2023. sTM levels were measured at 24 h and 48 h after patients' admissions into the hospital. There was a significant difference between the two groups (AIS: 23.2 ± 9.17 ng/mL vs. controls: 3.64 ± 1.72 ng/mL; p-value < 0.001). sTM values were correlated with the score of neurological deficits, with gender and dyslipidemia. The association of sTM values with the acute onset of AIS as an end point was significant, which allows rapid therapeutic interventions, even in the absence of a well-defined clinical syndrome (AUC = 0.99). Reanalysis of the patients after propensity score matching increased the power of sTM as a biomarker (AUC = 1). sTM represents a potentially useful biomarker to diagnose the onset of an AIS, even in scarce clinical presentations, which makes thrombomodulin a valuable indicator for early treatment initiation.

Keywords: acute ischemic stroke; biomarker; early diagnosis; thrombolysis; thrombomodulin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart presenting the selection process of the patients and controls included in this study. AIS: acute ischemic stroke.
Figure 2
Figure 2
(A) Comparative analysis of serum TM levels in patients with acute stroke (study group) and controls. (B) Receiver operating characteristic (ROC) curve depicting the area under the curve (AUC) for serum TM measurements within the initial 24 h of hospitalization. (C,D) The figures illustrate the same analyses after the popensity score matching.
Figure 3
Figure 3
Correlation analysis between serum TM levels at T1 (A) and at T2 (B), and NIHSS measured at patient presentation, 48 h and at discharge. R: Pearson correlation coefficient.
See this image and copyright information in PMC

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