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

• Type: Article in International Scientific Journal
• Date: 2024

Authors

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

Journal

Title: Stroke

Vol. 55

Pages: 2353-2358

ISSN: 0039-2499

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 1 Citation

Scopus - 1 Citation

Other information

Authenticus ID: 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6