Highlights
- •The serum NfL was a promising predictive biomarker for ischemic stroke outcome.
- •The patients with higher sNfL, compared with lower sNfL patients, had a 1.71 times higher risk of poor functional outcome during follow-up.
- •Blood sampling time was of great importance to make sNfL a significant predictor.
- •The temporal change of sNfL after stroke deserves further exploration in large longitudinal studies.
Abstract
Background: Stroke is the leading cause of death and long-term disability worldwide. The purpose
of the study is to examine the role of serum neurofilament light chain (sNfL) as a
predictive biomarker for ischemic stroke outcome. Methods: We searched PubMed, Web of Science, and EMBASE for potential studies published in
English previous to November 15, 2019. Two independent reviewers screened the search
results for studies reporting the correlation between sNfL and stroke outcome in ischemic
stroke or transient ischemic attack patients. The Newcastle-Ottawa Scale was adopted
to evaluate the quality of the included studies. The pooled odds ratio (OR) of sNfL
for stroke functional outcome was calculated with the Comprehensive Meta-Analysis
software, version 2. Heterogeneity and publication bias were assessed with the I2 test and funnel plot, respectively. Results: Seven studies met the inclusion criteria. The qualities of the included studies ranged
from moderate to high. Despite of the different methods used to measure infarct volume,
5 of the included studies reported similar results about the association between sNfL
and infarct volume. Two studies investigating the relationship between sNfL and recurrent
ischemic events both reported positive results. In pooled analysis with the adjusted
odds ratios (Ors) from multivariate regression models, the meta-analysis reached a
pooled adjusted OR = 1.71 [95% CI: 1.17-4.29], which represented that the patients
with higher sNfL, compared with lower sNfL patients, had a 1.71 times higher risk
of poor functional outcome during follow-up. Both meta-regression and subgroup analysis
found that sampling time was an important source of heterogeneity. Based on funnel
plot and Egger's test, we did not detect obvious publication bias in our study. Conclusions: The sNfL was a promising predictive biomarker for ischemic stroke outcome, and blood
sampling time was of great importance in the correlation. The temporal change of sNfL
after stroke deserves further exploration in large longitudinal studies and a standardized
procedure is warranted.
Key Words
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Article info
Publication history
Published online: April 16, 2020
Accepted:
March 13,
2020
Received:
December 13,
2019
Footnotes
Funding: This meta-analysis was supported by a grant from the National Natural Science Foundation of China [Grant No. 81471197].
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104813
Copyright
© 2020 Elsevier Inc. All rights reserved.
