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Endostatin as a novel prognostic biomarker in acute ischemic stroke.

Abstract：

BACKGROUND AND AIMS:Endostatin is implicated in the atherosclerosis process and serves as a promising cardiovascular biomarker, while its clinical significance in ischemic stroke patients remains unclear. We aimed to examine the association between endostatin and mortality and disability after ischemic stroke. METHODS:A total of 3463 acute ischemic stroke patients with measured plasma endostatin from the China Antihypertensive Trial in Acute Ischemic Stroke were included in this study. The primary outcome was death or severe disability (modified Rankin scale score of 4-6), and secondary outcomes included death and vascular events. RESULTS:After 3-month follow-up, 402 (11.61%) participants experienced severe disability or died. Compared with the lowest quartile of endostatin, odds ratios or hazard ratios (95% confidence intervals) for the highest quartile were 1.47 (1.04-2.09) for the primary outcome, and 2.36 (1.23-4.54) for death after adjustment for multiple covariates, including age, sex, admission NIH Stroke Scale score and systolic blood pressure. Each 1-SD higher log-transformed endostatin was associated with a 20% (6%-36%) increased risk for primary outcome. Adding plasma endostatin to the basic model constructed with conventional factors significantly improved risk stratification of primary outcome, as observed by the category-free net reclassification index of 20.5% (95% CI 10.1%-30.8%; p < 0.001) and integrated discrimination improvement of 0.3% (95% CI 0.01%-0.6%; p = 0.04). CONCLUSIONS:Increased baseline plasma endostatin levels in acute ischemic stroke were associated with increased risk of mortality and severe disability at 3 months. Plasma endostatin may serve as an important prognostic marker for risk stratification in patients with ischemic stroke.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Zhang C,Qian S,Zhang R,Guo D,Wang A,Peng Y,Peng H,Li Q,Ju Z,Geng D,Chen J,Zhang Y,He J,Zhong C,Xu T

doi

10.1016/j.atherosclerosis.2019.11.032

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

42-48

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(19)31603-X

journal_volume

293

pub_type

杂志文章,多中心研究,随机对照试验

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