Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection

Background: Although great progress has been made in surgery and perioperative care, stroke is still a fatal complication of acute type A aortic dissection (ATAAD). Serum biomarkers may help assess brain damage and predict patient's prognosis.Methods: From March, 2019 to January, 2020, a total...

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Autores principales:	Kai Zhang, Zhu Wang, Kai Zhu, Songbo Dong, Xudong Pan, Lizhong Sun, Qing Li
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	type A aortic dissection aortic operation stroke biomarker (BM) neurofilaments (NFs) Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/0e9248cdb4214fd091bfa025183f4ab0
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spelling	oai:doaj.org-article:0e9248cdb4214fd091bfa025183f4ab02021-11-11T06:10:10ZNeurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection2297-055X10.3389/fcvm.2021.754801https://doaj.org/article/0e9248cdb4214fd091bfa025183f4ab02021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.754801/fullhttps://doaj.org/toc/2297-055XBackground: Although great progress has been made in surgery and perioperative care, stroke is still a fatal complication of acute type A aortic dissection (ATAAD). Serum biomarkers may help assess brain damage and predict patient's prognosis.Methods: From March, 2019 to January, 2020, a total of 88 patients underwent surgical treatment at the Department of Cardiovascular Surgery of Beijing Anzhen Hospital, China, and were enrolled in this study. Patients were divided into two groups according to whether they had suffered a stroke after the operation. Blood samples were collected at 8 time points within 3 days after surgery to determine the level of S100β, neuron-specific enolase (NSE) and neurofilament light chain protein (NFL). Receiver operating characteristic curves (ROC) were established to explore the biomarker predictive value in stroke. The area under the curve (AUC) was used to quantify the ROC curve.Results: The patient average age was 48.1 ± 11.0 years old and 70 (79.6%) patients were male. Fifteen (17.0%) patients suffered stroke after surgery. The NFL levels of patients in the stroke group at 12 and 24 h after surgery were significantly higher than those in the non-stroke group (all P < 0.001). However, the NSE and S100β levels did not differ significantly at any time point between the two groups. The predictive value of NFL was the highest at 12 and 24 h after surgery, and the AUC was 0.834 (95% CI, 0.723–0.951, P < 0.001) and 0.748 (95% CI, 0.603–0.894, P = 0.004), respectively. Its sensitivity and specificity at 12 h were 86.7 and 71.6%, respectively. The NFL cutoff value for the diagnosis of stroke at 12 h after surgery was 16.042 ng/ml.Conclusions: This study suggests that NFL is an early and sensitive serum marker for predicting post-operative neurological prognosis of ATAAD patients. Further studies, including large-scale prospective clinical trials, are necessary to test whether the NFL can be used as a biomarker for clinical decision-making.Kai ZhangKai ZhangKai ZhangZhu WangZhu WangKai ZhuSongbo DongXudong PanLizhong SunQing LiQing LiFrontiers Media S.A.articletype A aortic dissectionaortic operationstrokebiomarker (BM)neurofilaments (NFs)Diseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	type A aortic dissection aortic operation stroke biomarker (BM) neurofilaments (NFs) Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	type A aortic dissection aortic operation stroke biomarker (BM) neurofilaments (NFs) Diseases of the circulatory (Cardiovascular) system RC666-701 Kai Zhang Kai Zhang Kai Zhang Zhu Wang Zhu Wang Kai Zhu Songbo Dong Xudong Pan Lizhong Sun Qing Li Qing Li Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection
description	Background: Although great progress has been made in surgery and perioperative care, stroke is still a fatal complication of acute type A aortic dissection (ATAAD). Serum biomarkers may help assess brain damage and predict patient's prognosis.Methods: From March, 2019 to January, 2020, a total of 88 patients underwent surgical treatment at the Department of Cardiovascular Surgery of Beijing Anzhen Hospital, China, and were enrolled in this study. Patients were divided into two groups according to whether they had suffered a stroke after the operation. Blood samples were collected at 8 time points within 3 days after surgery to determine the level of S100β, neuron-specific enolase (NSE) and neurofilament light chain protein (NFL). Receiver operating characteristic curves (ROC) were established to explore the biomarker predictive value in stroke. The area under the curve (AUC) was used to quantify the ROC curve.Results: The patient average age was 48.1 ± 11.0 years old and 70 (79.6%) patients were male. Fifteen (17.0%) patients suffered stroke after surgery. The NFL levels of patients in the stroke group at 12 and 24 h after surgery were significantly higher than those in the non-stroke group (all P < 0.001). However, the NSE and S100β levels did not differ significantly at any time point between the two groups. The predictive value of NFL was the highest at 12 and 24 h after surgery, and the AUC was 0.834 (95% CI, 0.723–0.951, P < 0.001) and 0.748 (95% CI, 0.603–0.894, P = 0.004), respectively. Its sensitivity and specificity at 12 h were 86.7 and 71.6%, respectively. The NFL cutoff value for the diagnosis of stroke at 12 h after surgery was 16.042 ng/ml.Conclusions: This study suggests that NFL is an early and sensitive serum marker for predicting post-operative neurological prognosis of ATAAD patients. Further studies, including large-scale prospective clinical trials, are necessary to test whether the NFL can be used as a biomarker for clinical decision-making.
format	article
author	Kai Zhang Kai Zhang Kai Zhang Zhu Wang Zhu Wang Kai Zhu Songbo Dong Xudong Pan Lizhong Sun Qing Li Qing Li
author_facet	Kai Zhang Kai Zhang Kai Zhang Zhu Wang Zhu Wang Kai Zhu Songbo Dong Xudong Pan Lizhong Sun Qing Li Qing Li
author_sort	Kai Zhang
title	Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection
title_short	Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection
title_full	Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection
title_fullStr	Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection
title_full_unstemmed	Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection
title_sort	neurofilament light chain protein is a predictive biomarker for stroke after surgical repair for acute type a aortic dissection
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/0e9248cdb4214fd091bfa025183f4ab0
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Neurofilament Light Chain Protein Is a Predictive Biomarker for Stroke After Surgical Repair for Acute Type A Aortic Dissection

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