Predictive value of plasma lipocalin-2 for the clinical outcome of patients with acute minor ischemic stroke / 国际脑血管病杂志

ABSTRACT

Objective:To investigate the predictive value of plasma lipocalin-2 (LCN2) for the clinical outcome of patients with acute minor ischemic stroke (MIS).Methods:Consecutive patients with acute MIS admitted to the Department of Neurology, Shengze Hospital Affiliated to Nanjing Medical University from October 9, 2017 to August 17, 2018 were selected prospectively. On the day of admission, the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological impairment. The modified Rankin Scale was used to evaluate the clinical outcome at 90 d after the onset, and 0-1 was defined as a good outcome. Multivariate logistic regression model was used to analyze the correlation between plasma LCN2 and clinical outcome. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma LCN2 for the clinical outcome of patients. Results:A total of 71 patients (68.99±11.24 years old) were enrolled in the study. Forty-six patients were male (64.8%). The median plasma LCN2 was 117.7 μg/L (interquartile range, 61.2-738.4 μg/L). Fifty-six patients (78.9%) had good outcomes, and 15 (21.1%) had poor outcomes. The age, baseline NIHSS score, plasma C-reactive protein and LCN2 of the good outcome group were significantly lower than those of the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that plasma LCN2 ≤117.7 μg/L (odds ratio 8.574, 95% confidence interval 1.755-41.874; P=0.008) and lower baseline NIHSS scores (for increasing by 1 point odds ratio 0.396, 95% confidence interval 0.214-0.732; P=0.003) were independently related to good outcome. ROC curve analysis showed that the area under the curve for plasma LCN2 to predict a good outcome was 0.814 (95% confidence interval 0.709-0.918); the best cut-off value was 128.55 μg/L, and the corresponding sensitivity and specificity were 69.6% and 80.0%, respectively. Conclusions:Plasma LCN2 had a good predictive value for the clinical outcome of patients with acute MIS at 90 d after the onset.