Early plasma biomarker dynamic profiles are associated with acute ischemic stroke outcomes

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Angela Maria Veloso Guimarães Carneiro

    Autor

  • Pedro Miguel Araújo Campos De Castro

    Autor

Participantes de fora da FMUP

  • Correia, M
  • Silva, I
  • Gabriel, D
  • Simren, J
  • Ribeiro, S
  • Doria, HM
  • Varela, R
  • Aires, A
  • Minta, K
  • Antunes, R
  • Felgueiras, R
  • Blenow, K
  • Magalhaes, R
  • Zetterberg, H
  • Maia, LF

Unidades de investigação

Abstract

Background Early outcome prediction after acute ischemic stroke (AIS) might be improved with blood-based biomarkers. We investigated whether the longitudinal profile of a multi-marker panel could predict the outcome of successfully recanalized AIS patients. Methods We used ultrasensitive single-molecule array (Simoa) to measure glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), total-tau (t-tau) and ELISA for brevican in a prospective study of AIS patients with anterior circulation large vessel occlusion successfully submitted to thrombectomy. Plasma was obtained at admission, upon treatment, 24 h and 72 h after treatment. Clinical and neuroimaging outcomes were assessed independently. Results Thirty-five patients (64.8%) had good early clinical or neuroimaging outcome. Baseline biomarker levels did not distinguish between outcomes. However, longitudinal intra-individual biomarker changes followed different dynamic profiles with time and according to outcome. GFAP levels exhibited an early and prominent increase between admission and just after treatment. NfL increase was less pronounced between admission and up to 24 h. T-tau increased between treatment and 24 h. Interestingly, GFAP rate-of-change (pg/ml/h) between admission and immediately after recanalization had a good discriminative capacity between clinical outcomes (AUC = 0.88, p < 0.001), which was higher than admission CT-ASPECTS (AUC = 0.75, p < 0.01). T-tau rate-of-change provided moderate discriminative capacity (AUC = 0.71, p < 0.05). Moreover, in AIS patients with admission CT-ASPECTS <9 both GFAP and NfL rate-of-change were good outcome predictors (AUC = 0.82 and 0.77, p < 0.05). Conclusion Early GFAP, t-tau and NfL rate-of-change in plasma can predict AIS clinical and neuroimaging outcome after successful recanalization. Such dynamic measures match and anticipate neuroimaging predictive capacity, potentially improving AIS patient stratification for treatment, and targeting individualized stroke care.

Dados da publicação

ISSN/ISSNe:
1468-1331, 1351-5101

European Journal of Neurology  Wiley-Blackwell Publishing Ltd

Tipo:
Article
Páginas:
1630-1642
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 8

Citações Recebidas na Scopus: 16

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Keywords

  • GFAP; NfL; outcome; plasma biomarkers; stroke; thrombectomy; total-tau

Financiamento

Proyectos asociados

A Resposta Inflamatória Sistémica está ligada com a Severidade do Edema Cerebral e Deterioração Neurológica após Recanalização em AVC isquémico

Investigador Principal: Pedro Miguel Araújo Campos de Castro

Estudo Clínico Académico (AVC isquémico) . 2020

Microemboli After Successful Thrombectomy Do Not Affect Outcome But Predict New Embolic Events

Investigador Principal: Pedro Miguel Araújo Campos de Castro

Estudo Clínico Académico (Thrombectomy) . 2020

Regulação Autonómica em Pacientes com Doença Arterial Aterosclerótica Intracraniana

Investigador Principal: Pedro Miguel Araújo Campos de Castro

Estudo Clínico Académico (AA) . 2020

Biomarcadores quantitativos na angiografia por tomografia de coerência óptica da Síndrome de Alport

Investigador Principal: Angela Maria Veloso Guimarães Carneiro

Estudo Clínico Académico . 2021

INFLAMMATORY CHOROIDAL NEOVASCULAR MEMBRANES: Clinical Profile, Treatment Effectiveness and Visual Prognosis

Investigador Principal: Angela Maria Veloso Guimarães Carneiro

Estudo Clínico Académico . 2021

Anemia and its association with global disability outcomes in stroke patients who underwent reperfusion therapy

Investigador Principal: Pedro Miguel Araújo Campos de Castro

Estudo Clínico Académico . 2021

Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke

Investigador Principal: Pedro Miguel Araújo Campos de Castro

Estudo Clínico Académico . 2021

Dynamic transcranial Doppler assessment in Heart Failure patients

Investigador Principal: Pedro Miguel Araújo Campos de Castro

Estudo Clínico Académico . 2020

The Impact of Very Short-term Variability of Blood Pressure in Outcome after Successful Thrombectomy

Investigador Principal: Pedro Miguel Araújo Campos de Castro

Estudo Clínico Académico . 2020

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