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Shi G, Li M, E Y, Wang M, Gong P, Wang X, Lu J, Wu W, Xue S, Zhou J, Zhou R. Prognostic performance of serum YKL-40 for one-year clinical outcomes in acute ischemic stroke. Aging (Albany NY) 2023; 15:1199-1209. [PMID: 36880855 PMCID: PMC10008488 DOI: 10.18632/aging.204553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Effects of YKL-40 on one-year clinical outcomes including poor clinical outcome, all-cause mortality, and stroke recurrence among acute ischemic stroke (AIS) patients remained elusive. The purpose of this study was to explore the association between serum YKL-40 at admission and one-year clinical outcomes in AIS patients. METHODS In this prospective cohort study, a total of 1002 participants out of 1361 AIS patients from two centers were included for current analysis. Serum YKL-40 concentrations were measured via enzyme-linked immunosorbent assay. Multivariable logistic or Cox regression were performed to explore the independent association of YKL-40 with one-year clinical outcomes, including poor outcome (modified Rankin Scale of 3-6), all-cause mortality, and recurrent stroke. C-statistic, net reclassification index (NRI) and integrated discrimination improvement (IDI) were calculated to evaluate the discriminatory and predictive power of YKL-40 when added to conventional model. RESULTS Compared with the first quartile of YKL-40, the adjusted odds ratios or hazard ratios with 95% confidence intervals of the fourth quartile were 3.032 (1.627-5.650) for poor outcome, 2.886 (1.320-6.308) for all-cause mortality and 1.694 (0.906-3.169) for recurrent stroke. The addition of serum YKL-40 to conventional model significantly improved reclassification for poor outcome (NRI 0.053, P = 0.031; IDI 0.018, P = 0.001) and all-cause mortality (NRI 0.162, P = 0.036). CONCLUSIONS Elevated serum YKL-40 at admission might be independently associated with one-year poor outcome and all-cause mortality but not stroke recurrence among Chinese AIS patients.
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Affiliation(s)
- Guomei Shi
- Department of Neurology, The Taixing People’s Hospital, Taixing 225400, Jiangsu Province, China.,Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Minghao Li
- Department of Vascular Surgery, The Taixing People’s Hospital, Taixing 225400, Jiangsu Province, China
| | - Yan E
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210001, Jiangsu Province, China
| | - Meng Wang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210001, Jiangsu Province, China
| | - Pengyu Gong
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210001, Jiangsu Province, China
| | - Xiaorong Wang
- Department of Neurology, The Taixing People’s Hospital, Taixing 225400, Jiangsu Province, China
| | - Jingye Lu
- Department of Neurology, The Taixing People’s Hospital, Taixing 225400, Jiangsu Province, China.,Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Weixiang Wu
- Department of Neurology, The Taixing People’s Hospital, Taixing 225400, Jiangsu Province, China
| | - Shouru Xue
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Junshan Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210001, Jiangsu Province, China
| | - Rujuan Zhou
- Department of Neurology, The Taixing People’s Hospital, Taixing 225400, Jiangsu Province, China
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