Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients

Mengshi Xu,1,* Liang Xu,2,* Huaping Du,1 Wanying Shan,1 Jie Feng,1 Guojie Zhai,1 Xiuyan Yang1 1Department of Neurology, Suzhou Ninth People’s Hospital, Suzhou, Jiangsu 215200, People’s Republic of China; 2Department of Anesthesiology, The First Affiliated Hospital of Soochow Univ...

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Autores principales:	Xu M, Xu L, Du H, Shan W, Feng J, Zhai G, Yang X
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	acute ischemic stroke retinoic acid early neurological deterioration functional outcome. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/febe0ed91ada43d9af14768eeb868d55
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spelling	oai:doaj.org-article:febe0ed91ada43d9af14768eeb868d552021-12-02T09:30:47ZDecreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients1178-2021https://doaj.org/article/febe0ed91ada43d9af14768eeb868d552020-06-01T00:00:00Zhttps://www.dovepress.com/decreased-serum-retinoic-acid-may-predict-poor-outcome-in-ischemic-str-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Mengshi Xu,1,* Liang Xu,2,* Huaping Du,1 Wanying Shan,1 Jie Feng,1 Guojie Zhai,1 Xiuyan Yang1 1Department of Neurology, Suzhou Ninth People’s Hospital, Suzhou, Jiangsu 215200, People’s Republic of China; 2Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiuyan Yang; Guojie Zhai Email yangxiuyan335@163.com; 125461985@qq.comBackground and Aims: Decreased serum retinoic acid (RA) levels have been shown to be linked with increased mortality in cardiovascular diseases. This study aimed to investigate the relationship between serum RA and 3-month functional outcome after ischemic stroke.Methods: Between January 2019 and September 2019, we prospectively recruited ischemic stroke patients within 24 hrs of symptom onset. Serum RA levels were measured for all patients at admission. The primary outcome was defined as poor functional outcome (modified Rankin Scale 3– 6) at 90 days. The secondary outcome was defined as early neurological deterioration (END), which is considered as an increase of ≥ 1 point in motor power or total National Institutes of Health Stroke Scale score of ≥ 2 points within 7 days.Results: A total of 217 patients were included in the analysis. The median RA levels were 2.9 ng/mL. Ninety-four (43.3%) and 65 (30.0%) patients experienced 3-month poor outcome and END, respectively. After adjusted for potential confounders, decreased levels of serum RA were associated with a higher risk of poor outcome (P for trend = 0.001) and END (P for trend = 0.002). Adding RA quartile to the existing risk factors improved risk prediction for poor outcome [net reclassification improvement (NRI) = 42.6%, P = 0.001; integrated discrimination improvement (IDI) = 5.7%, P = 0.001] and END (NRI index = 45.4%, P = 0.001; IDI = 4.3%; P = 0.005).Conclusion: Low serum RA levels at baseline were associated with poor prognosis at 90 days after ischemic stroke, suggesting that RA may be a potential prognostic biomarker for ischemic stroke.Keywords: acute ischemic stroke, retinoic acid, early neurological deterioration, functional outcomeXu MXu LDu HShan WFeng JZhai GYang XDove Medical Pressarticleacute ischemic strokeretinoic acidearly neurological deteriorationfunctional outcome.Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 1483-1491 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute ischemic stroke retinoic acid early neurological deterioration functional outcome. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	acute ischemic stroke retinoic acid early neurological deterioration functional outcome. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Xu M Xu L Du H Shan W Feng J Zhai G Yang X Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients
description	Mengshi Xu,1,* Liang Xu,2,* Huaping Du,1 Wanying Shan,1 Jie Feng,1 Guojie Zhai,1 Xiuyan Yang1 1Department of Neurology, Suzhou Ninth People’s Hospital, Suzhou, Jiangsu 215200, People’s Republic of China; 2Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiuyan Yang; Guojie Zhai Email yangxiuyan335@163.com; 125461985@qq.comBackground and Aims: Decreased serum retinoic acid (RA) levels have been shown to be linked with increased mortality in cardiovascular diseases. This study aimed to investigate the relationship between serum RA and 3-month functional outcome after ischemic stroke.Methods: Between January 2019 and September 2019, we prospectively recruited ischemic stroke patients within 24 hrs of symptom onset. Serum RA levels were measured for all patients at admission. The primary outcome was defined as poor functional outcome (modified Rankin Scale 3– 6) at 90 days. The secondary outcome was defined as early neurological deterioration (END), which is considered as an increase of ≥ 1 point in motor power or total National Institutes of Health Stroke Scale score of ≥ 2 points within 7 days.Results: A total of 217 patients were included in the analysis. The median RA levels were 2.9 ng/mL. Ninety-four (43.3%) and 65 (30.0%) patients experienced 3-month poor outcome and END, respectively. After adjusted for potential confounders, decreased levels of serum RA were associated with a higher risk of poor outcome (P for trend = 0.001) and END (P for trend = 0.002). Adding RA quartile to the existing risk factors improved risk prediction for poor outcome [net reclassification improvement (NRI) = 42.6%, P = 0.001; integrated discrimination improvement (IDI) = 5.7%, P = 0.001] and END (NRI index = 45.4%, P = 0.001; IDI = 4.3%; P = 0.005).Conclusion: Low serum RA levels at baseline were associated with poor prognosis at 90 days after ischemic stroke, suggesting that RA may be a potential prognostic biomarker for ischemic stroke.Keywords: acute ischemic stroke, retinoic acid, early neurological deterioration, functional outcome
format	article
author	Xu M Xu L Du H Shan W Feng J Zhai G Yang X
author_facet	Xu M Xu L Du H Shan W Feng J Zhai G Yang X
author_sort	Xu M
title	Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients
title_short	Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients
title_full	Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients
title_fullStr	Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients
title_full_unstemmed	Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients
title_sort	decreased serum retinoic acid may predict poor outcome in ischemic stroke patients
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/febe0ed91ada43d9af14768eeb868d55
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Decreased Serum Retinoic Acid May Predict Poor Outcome in Ischemic Stroke Patients

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