Serum CXCL12 predicts the outcomes after intravenous thrombolytic therapy in patients with acute ischemic stroke / 国际脑血管病杂志

ABSTRACT

Objective:To investigate the correlation between serum CXCL12 and the outcomes after intravenous thrombolytic therapy in patients with acute ischemic stroke.Methods:Consecutve patients with acute ischemic stroke treated with intravenous thrombolytic therapy in the Department of Neurology, the First Affiliated Hospital of Soochow University from January 1, 2020 to August 31, 2021 were enrolled retrospectively. Serum CXCL12 was measured by enzyme-linked immunosorbent assay within 24 h of onset. No improvement in early neurological function was defined as the National Institutes of Health Stroke Scale (NIHSS) 24 h after thrombolysis decreased by <4 compared with the baseline. The clinical outcome was evaluated by the modified Rankin Scale at 90 d after onset, and >2 were defined as a poor outcome. Multivariate logistic regression analysis was used to evaluate the correlation between serum CXCL12 and the outcome after intravenous thrombolysis, and the predictive value of serum CXCL12 for no improvement of early neurological function and poor short-term outcome was analyzed by the receiver operating characteristic (ROC) curve. Results:A total of 66 patients were enrolled, and the serum CXCL12 was 15.72±6.52 g/L. Twenty-seven patients (40.9%) had poor outcomes, and 34 (51.5%) had no improvement in early neurological function. Multivariate logistic regression analysis showed that higher serum CXCL12 was an independent predictor of poor outcome (odds ratio [ OR] 1.245, 95% confidence interval [ CI] 1.093-1.419; P=0.001) and no improvement in early neurological function ( OR 1.250, 95% CI 1.100-1.420; P=0.001). ROC curve analysis showed that the area under the curve of serum CXCL12 for predicting poor outcome was 0.793 (95% CI 0.679-0.908), the best cut-off value was 15.38 μg/L, and the corresponding sensitivity and specificity were 81.5% and 76.9%, respectively. The area under the curve of serum CXCL12 for predicting no improvement of early neurological function was 0.849 (95% CI 0.748-0.951), and the best cut-off value was 15.68 μg/L, and the corresponding sensitivity and specificity were 76.5% and 87.5%, respectively. Conclusion:Serum CXCL12 had a better predictive value for the outcomes of patients with acute ischemic stroke after intravenous thrombolytic therapy.