Prognostic Value of Cystatin C in Acute Ischemic Stroke Patients with Intravenous Thrombolysis

Author(s): Jijun Shi, Chunyuan Zhang, Yongjun Cao*, Xinyuan Qu, Huihui Liu, Shoujiang You

Journal Name: Current Neurovascular Research

Volume 16 , Issue 4 , 2019

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Abstract:

Background: Less is known about the prognostic value of serum cystatin C in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT). The aim of the present study was to examine the association between serum cystatin C levels and prognosis of AIS patients after IVT.

Methods: Serum cystatin C was measured within 24 hours after recombinant tissue plasminogen activator (rt-PA) treatment in 280 consecutively recruited patients with AIS. The main outcomes included combination of death and major disability, death, major disability (modified Rankin Scale score 3-5) and vascular events at 3-month follow-up.

Results: During the 3-month follow-up, 94 patients (33.6%) experienced death or major disability (28 deaths and 66 major disability) and 49 patients (17.5%) experienced vascular events. After multivariate adjustment, serum cystatin C was significantly associated with an increased risk of the combined outcome of death and major disability (OR=4.51, P = 0.006). Adding serum cystatin C quartiles to a model containing conventional risk factors improved the predictive power for the combined outcome of death and major disability (continuous net reclassification index 43.88%, P < 0.001; categorical net reclassification index 9.15%, P = 0.013; integrated discrimination improvement 2.31%, P = 0.025). Similar phenomena were also observed in major disability and vascular events.

Conclusion: Higher levels of serum cystatin C in AIS patients after IVT were independently associated with increased risks of poor functional outcomes and vascular events, especially combining conventional risk factors, suggesting that serum cystatin C might improve risk prediction for poor prognosis in AIS patients receiving rt-PA treatment.

Keywords: Cystatin C, acute ischemic stroke, intravenous thrombolysis, prognosis, cystatin, inflammation.

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VOLUME: 16
ISSUE: 4
Year: 2019
Page: [301 - 309]
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DOI: 10.2174/1567202616666190906110204
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