Association between serum netrin-1 levels and early neurological deterioration after acute ischemic stroke

So you're predicting early neurological deterioration but giving us NOTHING on how to prevent it. Useless. Do we have no one in the world that wants to solve stroke? I'd have you all fired.

Association between serum netrin-1 levels and early neurological deterioration after acute ischemic stroke

Zhuo Chen¹, Tianli Cao¹, Xingju Zhong¹, Yong Wu¹, Wei Fu¹, Chaoli Fan¹, Yu Jiang¹, Qi Zhou¹, Jie Peng¹, Jieyu Liao¹, Zhike You¹, Xin Yi¹ and Jingyu Tan^2*

• ¹Department of Neurology, Mianzhu People's Hospital, Mianzhu, China
• ²Department of Endocrinology, Mianzhu People's Hospital, Mianzhu, China

Background and purposes: Experimental studies demonstrated that netrin-1 (NT-1) has anti-inflammatory, tissue regeneration, and immune modulation properties. We aimed to discern the utility of NT-1 as a biomarker for assessing the risk of early neurological deterioration (END) after ischemic stroke.

Methods: This was a prospective study enrolling ischemic stroke patients with symptoms onset <24 h. Serum NT-1 concentrations were measured at admission. The National Institutes of Health Stroke Scale increased by ≥2 points and ≥4 points during the first 72 h after admission and was defined as END2 and END4, respectively.

Results: The study included 268 patients (146 men and 122 women) with a mean age of 63.0 ± 9.6 years. The median NT-1 concentrations were 466.4 pg/ml (interquartile range, 341.4–589.2 pg/ml). During the initial 72 h after admission, END2 was found in 83 (31.0%) patients, and END4 was observed in 48 (17.9%) subjects. After adjusted for potential confounders, multivariate analysis indicated that decreased NT-1 levels is an independent predictor for END2 [odds ratio (OR) 0.62, 95% confidence interval (CI) 0.46–0.84, p < 0.001) and END4 (OR 0.53, 95% CI 0.36–0.76, p < 0.001). Similar results were found when the NT-1 levels were analyzed as a categorical variable. Furthermore, restricted cubic spline analysis showed a linear association between NT-1 concentrations and the risk of END (END2, p = 0.006 for linearity; END4, p < 0.001 for linearity).

Conclusions: Our results suggest that decreased NT-1 levels were significantly associated with a higher risk of END after ischemic stroke.

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