Akut iskemik inmede serum iskemiye modifiye albümin düzeyleri ile prognoz arasındaki ilişki

Öz

Amaç: Bu çalışmada, acil serviste akut iskemik inme (AİS) tanısı alan erişkin hastalarda serum iskemiye modifiye albümin (İMA) düzeyleri ile inme şiddeti ve fonksiyonel sonuçlar arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntem: Prospektif gözlemsel tasarımla yürütülen çalışmaya, 40 AİS hastası ve yaş-cinsiyet açısından eşleştirilmiş 20 sağlıklı kontrol alındı. Serum İMA düzeyleri başvuru anında ticari ELISA kiti ile ölçüldü. İnme şiddeti Ulusal Sağlık Enstitüleri İnme Ölçeği (NIHSS) ile değerlendirildi. Üçüncü ay fonksiyonel sonuçları, modifiye Rankin Skalası (mRS) ile belirlendi ve mRS ≥2 kötü fonksiyonel sonuç (KFS) olarak tanımlandı. Bulgular: Medyan İMA düzeyleri AİS grubunda kontrol grubuna göre anlamlı derecede yüksekti. Yüksek İMA düzeyleri, AİS (düzeltilmiş OR: 1,18; %95 GA: 1,03–1,35; p = 0,015), şiddetli inme (düzeltilmiş OR: 1,38; %95 GA: 1,06–1,83; p = 0,018) ve 3. ayda KFS (düzeltilmiş OR: 1,16; %95 GA: 1,04–1,30; p = 0,008) ile bağımsız olarak ilişkiliydi. ROC analizi, AİS için >58 ng/mL (EAA: 0,859), şiddetli inme için >76,7 ng/mL (EAA: 0,890) ve KFS için >65,4 ng/mL (EAA: 0,854) eşik değerlerini belirledi. Sonuçlar: Serum İMA düzeyleri, AİS hastalarında artmakta ve hem başlangıç inme şiddeti hem de uzun dönem fonksiyonel sonuçlarla ilişkili bulunmaktadır. İMA, AİS’te erken risk sınıflaması için hızlı ve düşük maliyetli bir biyobelirteç olarak kullanılma potansiyeline sahiptir.

Anahtar Kelimeler

• Akut iskemik inme
• iskemiye modifiye albümin
• oksidatif stres
• prognoz
• modifiye Rankin Skalası
• NIHSS
• biyobelirteç.

The relationship between serum ischemia-modified albumin levels and prognosis in acute ischemic stroke

Öz

Aim: This study aimed to investigate the association between serum ischemia-modified albumin (IMA) levels, stroke severity, and functional outcomes in adult patients diagnosed with acute ischemic stroke (AIS) in the emergency department. Material and Methods: In this prospective observational study, 40 AIS patients and 20 age- and sex-matched healthy controls were enrolled. Serum IMA levels were measured at admission using a commercial ELISA kit. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes at 3 months were determined using the modified Rankin Scale (mRS), with scores ≥2 defined as poor functional outcome (PFO). Results: Median IMA levels were significantly higher in AIS patients than controls. Elevated IMA was independently associated with AIS (adjusted OR: 1.18, 95% CI: 1.03–1.35, p = 0.015), severe stroke (adjusted OR: 1.38, 95% CI: 1.06–1.83, p = 0.018), and PFO at 3 months (adjusted OR: 1.16, 95% CI: 1.04–1.30, p = 0.008). ROC analysis identified IMA cutoffs of >58 ng/mL for AIS (AUC: 0.859), >76.7 ng/mL for severe stroke (AUC: 0.890), and >65.4 ng/mL for PFO (AUC: 0.854). Conclusion: Serum IMA levels are elevated in AIS and correlate with both initial stroke severity and short-term functional outcomes. IMA may serve as a rapid, cost-effective biomarker for early risk stratification in AIS.

Anahtar Kelimeler

• cute ischemic stroke
• ischemia-modified albumin
• oxidative stress
• prognosis
• modified Rankin Scale
• NIHSS
• biomarker

Etik Beyan

The study was performed in accordance with the Declaration of Helsinki, and was approved by Bursa Uludağ University Clinical Research Ethics Committee (Date: 16.05.2023, Decision No: 2023-11/21).

Kaynakça

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