Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor
Background: The increasing incidence of ischemic stroke has led to the search for a novel biomarker to predict the course of disease and the risk of mortality. Recently, the role of the soluble urokinase plasminogen activator receptor (suPAR) as a biomarker and indicator of immune system activation...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/3/457 |
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| author | Katarzyna Śmiłowska Marek Śmiłowski Robert Partyka Danuta Kokocińska Przemysław Jałowiecki |
| author_facet | Katarzyna Śmiłowska Marek Śmiłowski Robert Partyka Danuta Kokocińska Przemysław Jałowiecki |
| author_sort | Katarzyna Śmiłowska |
| collection | DOAJ |
| description | Background: The increasing incidence of ischemic stroke has led to the search for a novel biomarker to predict the course of disease and the risk of mortality. Recently, the role of the soluble urokinase plasminogen activator receptor (suPAR) as a biomarker and indicator of immune system activation has been widely examined. Therefore, the aim of the current study was to assess the dynamics of changes in serum levels of suPAR in ischemic stroke and to evaluate the prognostic value of suPAR in determining mortality risk. Methods: Eighty patients from the Department of Neurology, diagnosed with ischemic stroke, were enrolled in the study. Residual blood was obtained from all the patients on the first, third and seventh days after their ischemic stroke and the concentrations of suPAR and C-reactive protein (CRP), as well as the number of leukocytes and National Institute of Health’s Stroke Scale (NIHSS) scores, were evaluated. Results: On the first day of ischemic stroke, the average suPAR concentration was 6.55 ng/mL; on the third day, it was 8.29 ng/mL; on the seventh day, it was 9.16 ng/mL. The average CRP concentration on the first day of ischemic stroke was 4.96 mg/L; on the third day, it was 11.76 mg/L; on the seventh day, it was 17.17 mg/L. The number of leukocytes on the first day of ischemic stroke was 7.32 × 10<sup>3</sup>/mm<sup>3</sup>; on the third day, it was 9.27 × 10<sup>3</sup>/mm<sup>3</sup>; on the seventh day, it was 10.41 × 10<sup>3</sup>/mm<sup>3</sup>. Neurological condition, which was assessed via the NIHSS, on the first day of ischemic stroke, was scored at 10.71 points; on the third day, it was scored at 12.34 points; on the seventh day, it was scored at 13.75 points. An increase in the values of all the evaluated parameters on the first, third and seventh days of hospitalisation was observed. The patients with hypertension, ischemic heart disease and type 2 diabetes showed higher suPAR and CRP concentrations at the baseline as well as on subsequent days of hospitalisation. The greatest sensitivity and specificity were characterised by suPAR-3, where a value above 10.5 ng/mL resulted in a significant increase in mortality risk. Moreover, an NIHSS-1 score above 12 points and a CRP-3 concentration above 15.6 mg/L significantly increased the risk of death in the course of the disease. Conclusions: The plasma suPAR concentration after ischemic stroke is strongly related to the patient’s clinical status, with a higher concentration on the first and third days of stroke resulting in a poorer prognosis at a later stage of treatment. Therefore, assessing the concentration of this parameter has important prognostic value. |
| first_indexed | 2024-03-09T13:39:17Z |
| format | Article |
| id | doaj.art-598c7896eda7404380f466b1c2bb8b5f |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T13:39:17Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-598c7896eda7404380f466b1c2bb8b5f2023-11-30T21:08:44ZengMDPI AGJournal of Personalized Medicine2075-44262022-03-0112345710.3390/jpm12030457Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator ReceptorKatarzyna Śmiłowska0Marek Śmiłowski1Robert Partyka2Danuta Kokocińska3Przemysław Jałowiecki4Department of Emergency Medicine, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, PolandBackground: The increasing incidence of ischemic stroke has led to the search for a novel biomarker to predict the course of disease and the risk of mortality. Recently, the role of the soluble urokinase plasminogen activator receptor (suPAR) as a biomarker and indicator of immune system activation has been widely examined. Therefore, the aim of the current study was to assess the dynamics of changes in serum levels of suPAR in ischemic stroke and to evaluate the prognostic value of suPAR in determining mortality risk. Methods: Eighty patients from the Department of Neurology, diagnosed with ischemic stroke, were enrolled in the study. Residual blood was obtained from all the patients on the first, third and seventh days after their ischemic stroke and the concentrations of suPAR and C-reactive protein (CRP), as well as the number of leukocytes and National Institute of Health’s Stroke Scale (NIHSS) scores, were evaluated. Results: On the first day of ischemic stroke, the average suPAR concentration was 6.55 ng/mL; on the third day, it was 8.29 ng/mL; on the seventh day, it was 9.16 ng/mL. The average CRP concentration on the first day of ischemic stroke was 4.96 mg/L; on the third day, it was 11.76 mg/L; on the seventh day, it was 17.17 mg/L. The number of leukocytes on the first day of ischemic stroke was 7.32 × 10<sup>3</sup>/mm<sup>3</sup>; on the third day, it was 9.27 × 10<sup>3</sup>/mm<sup>3</sup>; on the seventh day, it was 10.41 × 10<sup>3</sup>/mm<sup>3</sup>. Neurological condition, which was assessed via the NIHSS, on the first day of ischemic stroke, was scored at 10.71 points; on the third day, it was scored at 12.34 points; on the seventh day, it was scored at 13.75 points. An increase in the values of all the evaluated parameters on the first, third and seventh days of hospitalisation was observed. The patients with hypertension, ischemic heart disease and type 2 diabetes showed higher suPAR and CRP concentrations at the baseline as well as on subsequent days of hospitalisation. The greatest sensitivity and specificity were characterised by suPAR-3, where a value above 10.5 ng/mL resulted in a significant increase in mortality risk. Moreover, an NIHSS-1 score above 12 points and a CRP-3 concentration above 15.6 mg/L significantly increased the risk of death in the course of the disease. Conclusions: The plasma suPAR concentration after ischemic stroke is strongly related to the patient’s clinical status, with a higher concentration on the first and third days of stroke resulting in a poorer prognosis at a later stage of treatment. Therefore, assessing the concentration of this parameter has important prognostic value.https://www.mdpi.com/2075-4426/12/3/457strokeischemiabiomarkersmortality risk |
| spellingShingle | Katarzyna Śmiłowska Marek Śmiłowski Robert Partyka Danuta Kokocińska Przemysław Jałowiecki Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor Journal of Personalized Medicine stroke ischemia biomarkers mortality risk |
| title | Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor |
| title_full | Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor |
| title_fullStr | Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor |
| title_full_unstemmed | Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor |
| title_short | Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor |
| title_sort | personalised approach to diagnosing and managing ischemic stroke with a plasma soluble urokinase type plasminogen activator receptor |
| topic | stroke ischemia biomarkers mortality risk |
| url | https://www.mdpi.com/2075-4426/12/3/457 |
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