Plasma Brain-Derived Tau in Prognosis of Large Vessel Occlusion Ischemic Stroke

• Tipo: Artigo em Revista Científica Internacional
• Data: 2024

Autores

Varela, R (Autor) Outra; Gonzalez-Ortiz, F (Autor) Outra; Dias, A (Autor) Outra; Knuth, NL (Autor) Outra; Fonte, J (Autor) Outra; Pinto, B (Autor) Outra; Yuksekel, I (Autor) Outra; Abreu, V (Autor) Outra; Silva, I (Autor) Outra; Igreja, L (Autor) Outra; Lopes, J (Autor) Outra; Silva, J (Autor) Outra; Dias, R (Autor) Outra; Filipe, JP (Autor) Outra; Malaquias, MJ (Autor) Outra; Moutinho, A (Autor) Outra; Gabriel, D (Autor) Outra; Aires, A (Autor) FMUP; Antunes, R (Autor) Outra; Rocha, JP (Autor) Outra; Felgueiras, R (Autor) Outra; Almendra, R (Autor) Outra; Castro, P (Autor) Outra; Zetterberg, H (Autor) Outra; Magalhaes, R (Autor) ICBAS; Karikari, TK (Autor) Outra; Correia, M (Autor) Outra; Blennow, K (Autor) Outra; Maia, LF (Autor) Outra

Revista

Título: Stroke

Vol. 55

Páginas: 2353-2358

ISSN: 0039-2499

Editora: Wolters Kluwer Health

Indexação

ISI Web of Knowledge - 1 Citação

Scopus - 1 Citação

Outras Informações

ID Authenticus: P-011-3GB

DOI: 10.1161/strokeaha.123.046117

Abstract (EN): BACKGROUND: Large vessel occlusion acute ischemic stroke prognosis improved following the 2015 endovascular therapy (EVT) trials. Blood-based biomarkers may improve outcome prediction. We aimed to assess plasma brain-derived tau (BD-Tau) performance in predicting post-EVT large vessel occlusion acute ischemic stroke outcomes. METHODS: We included 2 temporally independent prospective cohorts of anterior circulation in patients with large vessel occlusion acute ischemic stroke who successfully recanalized post-EVT. We measured plasma BD-Tau, GFAP (glial-fibrillary-acidic-protein), NfL (neurofilament-light-chain), and total-Tau upon admission, immediately, 24 hours, and 72 hours post-EVT. Twenty-four-hour neuroimaging and 90-day functional outcomes were independently assessed using the Alberta Stroke Program Early Computed Tomography Score (good outcome: >7 or unchanged) and the modified Rankin Scale (favorable outcome <3 or unchanged), respectively. Based on the first cohort (derivation), we built a multivariable logistic regression model to predict a 90-day functional outcome. Model results were evaluated using the second cohort (evaluation). RESULTS: In the derivation cohort (n=78, mean age=72.9 years, 50% women), 62% of patients had a good 24-hour neuroimaging outcome, and 45% had a favorable 90-day functional outcome. GFAP admission-to-EVT rate-of-change was the best predictor for early neuroimaging outcome but not for 90-day functional outcome. At admission, BD-Tau levels presented the highest discriminative performance for 90-day functional outcomes (area under the curve, 0.76 [95% CI, 0.65-0.87]; P<0.001). The model incorporating age, admission BD-Tau, and 24-hour Alberta Stroke Program Early Computed Tomography Score achieved excellent discrimination of 90-day functional outcome (area under the curve, 0.89 [95% CI, 0.82-0.97]; P<0.001). The score's predictive performance was maintained in the evaluation cohort (n=66; area under the curve, 0.82 [95% CI, 0.71-0.92]; P<0.001). CONCLUSIONS: Admission plasma BD-Tau accurately predicted 90-day functional outcomes in patients with large vessel occlusion acute ischemic stroke after successful EVT. The proposed model may predict functional outcomes using objective measures, minimizing human-related biases and serving as a simplified prognostic tool for AIS.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 6