A novel prognosis prediction model, including cytotoxic T lymphocyte-associated antigen-4, ischemia-modified albumin, lipoprotein-associated phospholipase A2, glial fibrillary acidic protein, and homocysteine, for ischemic stroke in the Chinese hypertensive population

J Clin Lab Anal. 2021 May;35(5):e23756. doi: 10.1002/jcla.23756. Epub 2021 Mar 18.

Abstract

Background: There is still a lack of tools to assess the prognosis of ischemic stroke patients induced by hypertension. In this study, we built a novel prognostic assessment model for ischemic stroke in the Chinese hypertensive population.

Methods: Mass spectrometry technique was used to analyze the changes in serum protein profiles of hypertensive patients with ischemic stroke. A total of 314 hypertensive patients were divided into the testing group (206 patients) and the validation group (108 patients).

Results: Compared with hypertensive patients without ischemic stroke, serum cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), ischemia-modified albumin (IMA), lipoprotein-associated phospholipase A2 (Lp-PLA2), glial fibrillary acidic protein (GFAP), and homocysteine (HCY) levels were significantly increased among hypertensive patients with ischemic stroke (p < 0.05). Then, we built a novel prognostic assessment model for hypertensive patients with ischemic stroke [Logit(P) = 29.172-1.088*CTLA-4-0.952*IMA-0.537*Lp-PLA2 -0.066*GFAP -0.149*HCY]. It showed higher efficiency (AUC = 0.981, sensitivity = 95.5%, specificity = 93.8%) than any single marker. The estimated probability was 0.739, which means if higher than 0.739, it was classified into poor prognosis. Compared with the estimated probability ≤0.739 group, the survival rate of hypertensive patients with ischemic stroke in the estimated probability >0.739 group was significantly decreased (χ2 = 40.001, p < 0.001). In the validation group, our novel prognostic assessment model still showed good efficiency (AUC = 0.969, sensitivity = 89.4%, specificity = 92.5%; χ2 = 47.551, p < 0.001).

Conclusion: Current novel prognostic assessment model we have built is of great value in the prognostic evaluation for ischemic stroke in the Chinese hypertensive population.

Keywords: hypertension; inflammation; ischemic stroke; mass spectrometry; prognosis.

MeSH terms

  • 1-Alkyl-2-acetylglycerophosphocholine Esterase / blood*
  • Asian People*
  • Biomarkers / blood
  • CTLA-4 Antigen / blood*
  • China
  • Female
  • Glial Fibrillary Acidic Protein / blood*
  • Homocysteine / blood*
  • Humans
  • Hypertension / blood*
  • Ischemic Stroke / blood*
  • Ischemic Stroke / diagnosis
  • Logistic Models
  • Male
  • Mass Spectrometry
  • Middle Aged
  • Models, Biological
  • Prognosis
  • Proteomics
  • ROC Curve
  • Reproducibility of Results
  • Serum Albumin, Human

Substances

  • Biomarkers
  • CTLA-4 Antigen
  • Glial Fibrillary Acidic Protein
  • ischemia-modified albumin
  • Homocysteine
  • 1-Alkyl-2-acetylglycerophosphocholine Esterase
  • Serum Albumin, Human