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

Autores da FMUP
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
- Tipo:
- Article
- Páginas:
- 1630-1642
- DOI:
- 10.1111/ene.15273
- Link para outro recurso:
- www.scopus.com
European Journal of Neurology Wiley-Blackwell Publishing Ltd
Citações Recebidas na Web of Science: 8
Citações Recebidas na Scopus: 16
Documentos
- Não há documentos
Filiações
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
Citar a publicação
Correia M,Silva I,Gabriel D,Simren J,Carneiro A,Ribeiro S,Doria HM,Varela R,Aires A,Minta K,Antunes R,Felgueiras R,Castro P,Blenow K,Magalhaes R,Zetterberg H,Maia LF. Early plasma biomarker dynamic profiles are associated with acute ischemic stroke outcomes. Eur. J. Neurol. 2022. 29. (6):p. 1630-1642. IF:5,100. (1).