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.

• Authors: Chenhuan Zhang, Sifan Qian, Rui Zhang, Daoxia Guo, Aili Wang, Yanbo Peng, Hao Peng, Qunwei Li, Zhong Ju, Deqin Geng, Jing Chen, Yonghong Zhang, Jiang He, Chongke Zhong, Tan Xu
• Journal: Atherosclerosis (Atherosclerosis) Vol. 293 Pg. 42-48 (01 2020) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 31835040 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 Elsevier B.V. All rights reserved.

Chemical References

• Biomarkers
• Endostatins

Topics

• Acute Disease
• Biomarkers (blood)
• Brain Ischemia (blood, epidemiology)
• China (epidemiology)
• Endostatins (blood)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Risk Factors