Plasma Dickkopf-1 predicts early neurological deterioration and outcome in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4165.2021.07.003
- VernacularTitle:血浆Dickkopf-1预测急性缺血性卒中患者的早期神经功能恶化和转归
- Author:
Kejin YIN
1
;
Liqin LUAN
;
Xiaoli HUA
;
Xuejun WANG
;
Jian SUN
;
Chengfang WU
;
Wenbin WANG
Author Information
1. 南通大学附属南京江北医院神经内科，南京 210000
- Keywords:
Stroke;
Brain ischemia;
Intercellular signaling peptides and proteins;
Disease progression;
Treatment outcome;
Predictive value of tests;
Risk factors;
Bioma
- From:
International Journal of Cerebrovascular Diseases
2021;29(7):491-496
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between plasma Dickkopf-1 and early neurological deterioration (END) and outcome in patients with acute ischemic stroke.Methods:From January 2020 to December 2020, consecutive patients with first-ever ischemic stroke form the Department of Neurology, Nanjing Jiangbei Hospital were included. All patients were hospitalized within 24 h after onset. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score within 7 d after admission increased by ≥2 or motor function score increased by ≥1 compared with the baseline. Poor outcome was defined as the modified Rankin Scale score >2 at 90 d after onset. Multivariate logistic regression analysis was used to determine the independent correlation between plasma Dickkopf-1 and END and outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma Dickkopf-1 for END and poor outcome. Results:A total of 176 patients were enrolled, including 92 males (52.3%), aged 66.7±9.6 years. The median Dickkopf-1 was 4.30 μg/L, 52 patients (29.5%) developed END, and 81 (46.0%) had poor outcome. Multivariate logistic regression analysis showed that the higher Dickkopf-1 was an independent predictor of END (odds ratio [ OR] 1.696, 95% confidence interval [ CI] 1.223-2.351; P=0.002) and poor outcome ( OR 1.566, 95% CI 1.156-2.121; P=0.004). ROC curve analysis showed that plasma Dickkopf-1 had good predictive value for END, and its area under the curve was 0.717 (95% CI 0.634-0.801); the optimal cut-off value was 4.40 μg/L, and the corresponding predictive sensitivity and specificity were 71.2% and 60.5%, respectively. Dickkopf-1 also had good predictive value for poor outcome, and its area under the curve was 0.701 (95% CI 0.624-0.778); the optimal cut-off value was 4.25 μg/L, and the corresponding predictive sensitivity and specificity were 65.4% and 61.1%, respectively. Conclusion:Plasma Dickkopf-1 has good predictive value for END and poor outcome in patients with acute ischemic stroke.
