Abstract
Objectives
Stroke is a frequently encountered life-threatening medical condition in emergency
departments (EDs). Despite all worldwide efforts, a reliable circulating biomarker
has not been identified yet. This study investigates the diagnostic and prognostic
value of neurogranin (Ng) in acute ischemic stroke (AIS).
Methods
This prospective case-control study was conducted on ED patients with AIS and healthy
volunteers. We collected the basic demographics, measured serum Ng levels of the patients
vs. controls, and followed up the patient group for 6-month by phone or clinical notes
to assess the functional outcomes.
Results
Data analysis was completed with 142 subjects (86 patients vs. 55 controls). The groups
did not differ in terms of age and gender. The median serum Ng level of the patient
group was significantly higher compared to the control group [160.00 (75.93) vs. 121.26
(90.35) ng/mL and p ˂ 0.001, respectively]. Serum Ng level of 25 patients admitted to the ED within the
first 6 hours from the onset of AIS was 177.93 (24.03) ng/mL, while serum Ng level
of 61 patients admitted to the ED within 6-24 hours was 131.84 (76.44) ng/mL. AUROC
results were 0.717 vs. 0.868 vs. 0.874 for stroke patients admitted during the first
24 hours, 6 hours, and 4.5 hours after the onset, respectively. Lesion volume, NIHSS,
and modified Rankin Scale scores (mRS) at admission showed no significant correlation
with Ng levels as well as 6-month mortality and 6-month mRS.
Conclusions
Timely AIS diagnosis is still a challenge for emergency departments due to the dependency
on imaging. Serum Ng can be a promising diagnostic biomarker for AIS patients admitted
in the first 24 hours. Even it outperformed in the first 4.5 and 6-hour time windows.
However, it did not show a significant prognostic value.
Keywords
Abbreviations:
ED (emergency department), CT (computed tomography), MRI (magnetic resonance imaging), HS (hemorrhagic stroke), SAH (subarachnoid hemorrhage), IS (ischemic stroke), AIS (acute ischemic stroke), IV tPA (thrombolysis with intravenous tissue-type plasminogen activator), MT (mechanical thrombectomy), Ng (Neurogranin), GCS (Glasgow coma scale), NIHSS (national institutes of health stroke scale), mRS (modified rankin scale), DWI (diffusion-weighted imaging), ELISA (enzyme-related immunosorbent assay), HT (hypertension), DM (diabetes mellitus), AF (atrial fibrillation), LV (lesion volume), SD (standard deviation), IQR (interquartile range), AUROC (area under the receiver operating characteristic curve), CI (confidence interval), CSF (cerebrospinal fluid), CNS (central nervous system), AD (Alzheimer's disease), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 05, 2022
Accepted:
November 8,
2022
Received in revised form:
November 5,
2022
Received:
July 13,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106889
Copyright
© 2022 Published by Elsevier Inc.
