Background and purpose:
Soluble isoforms of receptor for advanced glycation end products (sRAGE) and subtypes have been recognized as contradictory biomarkers of ischemic stroke. We sought to investigate whether the plasma levels of sRAGE and subtypes can predict unfavorable outcome and recurrence in acute ischemic stroke patients.
Methods:
The data used in this study was from the Third China National Stroke Registy (CNSR III), which was a nationwide, prospective cohort study to register acute ischemic stroke and transient ischemic attack patients. Plasma levels of sRAGE and subtypes were tested by enzyme-linked immunoabsorbent assay (ELISA) method and demonstrated by quartiles. Cox proportional hazards model was used to analysis the association of sRAGE and subtypes with unfavorable outcomes or stroke recurrence at 3- and 12-month in acute ischemic stroke patients, respectively. Unfavorable outcome was defined as modified Rankin Scale (mRS) 3-6.
Results:
Three thousand one hundred and eighty-nine acute ischemic stroke patients were included and tested for plasma level of sRAGE and subtypes (cRAGE and esRAGE) in this study. Mean age was 62.8±11.5 years and 2161 (67.8%) were male. At 3- and 12-month, there were 426 (13.5%) and 409 (13.1%) patients with an unfavorable outcome and 185 (5.9%) and 293 (9.2%) patients with stroke recurrence, respectively. Refered by quartile one of sAGRE, the adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) of unfavorable outcomes in quartile two to four were 0.81 (0.59-1.10), 0.66 (0.48-0.92) and 0.65 (0.47-0.91) at 3-month and 0.79 (0.58-1.08), 0.61 (9.44-0.85) and 0.66 (0.48-0.91) at 12-month; those of stroke recurrence in quartile two to four were 0.99 (0.66-1.49), 0.99 (0.66-1.49) and 1.02 (0.68-1.54) at 3-month and 1.05 (0.76-1.45), 0.95 (0.68-1.32) and 1.07 (0.77-1.48) at 12-month, respectively. Same data trends were found in subtypes cRAGE and esRAGE.
Conclusion:
Plasma levels of sRAGE and subtypes were protective biomarkers of unfavorable outcomes but not those of stroke recurrence in acute ischemic stroke patients.