Association of biomarker levels with early neurological deterioration and post-stroke cognitive impairment in pa-tients with acute partial anterior circulation infarction with cerebral microbleeds
Objective To investigate the changes in the serum levels of S100β,soluble intercellular adhesion mol-ecule-1(sICAM-1),oxidized low-density lipoprotein(ox-LDL),and soluble cluster of differentiation 40 ligand(sCD40L)in patients with acute partial anterior circulation infarction(PACI)with cerebral microbleeds(CMBs),as well as the association of each index with early neurological deterioration(END)and post-stroke cognitive impairment(PSCI)after non-thrombolytic therapy.Methods A total of 236 patients with acute PACI and CMBs who were admitted to our hospital from January 2020 to June 2022 were enrolled as subjects.The onset of END and PSCI within 6 months after treat-ment was recorded,and the association of the serum levels of S100β,sICAM-1,ox-LDL,and sCD40L with the onset of END and PSCI was analyzed.A logistic stepwise regression analysis was used to investigate the risk factors for END and PSCI,and the receiver operating characteristic(ROC)curve was plotted to analyze the early prediction efficiency of each index.Results The degree of carotid stenosis,the severity of CMBs,NIHSS score on admission,and the serum levels of Hcy,S100β protein,sICAM-1,ox-LDL,and sCD40L on admission were independent risk factors for END(P＜0.05).END,NIHSS score after 7 days of treatment,and the serum levels of S100β protein,sICAM-1,ox-LDL,and sCD40L af-ter 7 days of treatment were independent risk factors for PSCI(P＜0.05).Common risk factors such as NIHSS score,de-gree of carotid stenosis,and severity of CMBs combined with serum S100β protein,sICAM-1,ox-LDL,and sCD40L had an area under the ROC curve of 0.887 in predicting END in the early stage of non-thrombolytic therapy and 0.912 in pre-dicting END within 6 months after treatment,with a significantly greater AUC than each risk factor alone.Conclusion In PACI patients with CMBs,the onset of END and PSCI in the early stage of non-thrombolytic therapy are closely associated with brain tissue injury,vascular endothelial injury,oxidative stress,and vascular inflammatory response.Dynamic moni-toring of the serum levels of S100β protein,sICAM-1,ox-LDL,sCD40L combined with common risk factors such as NIHSS score and the severity of CMBs has important clinical significance in predicting the onset of END and PSCI in the early stage,guiding clinical diagnosis and treatment,and improving the prognosis of pa-tients.
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