The Predictive Value Of CXCL12 And SVCAM-1 Levels On The Risk Of Ischemic Stroke After Transient Ischemic Attack

Objective:To determine the predictive value of chemokine CXCL12 and sVCAM-1 in predicting the short-term incidence of ischemic stroke(within 7 days)after transient ischemic attack(TIA).Methods:We recruited 104 cases of TIA treated in Department of Neurology,Binzhou Medical University Hospital from July 2015 to February 2017.We collected their baseline characteristics,detected the serum levels of chemokine CXCL12 and sVCAM-1 and assigned 25 of them with ischemic stroke within 7 days after TIA to ischemic stroke group,and other 79 without to non-ischemic stroke group.Results:The average levels of HCY,chemokine CXCL12 and sVCAM-1 as well as average ABCD2 score of ischemic stroke patients were significantly higher than those of non-ischemic stroke patients(P<0.05).Multivariate Logistic regression analysis showed that hemokine CXCL12(OR=1.454,95%CI(1.133,1.866))and sVCAM-1(OR=1.008,95%Cl(1.003,1.014))were risk factors for ischemic stroke shortly after TIA(P<0.05).The levels of hemokine CXCL12 and sVCAM-1 increased with the growth of ABCD2 score,namely,the levels of chemokine CXCL12 and sVCAM-1 increased successively in patients with ABCD2 score of 0-3(low-risk of ischemic stroke),ABCD2 score of 4-5(medium-risk of ischemic stroke)and ABCD2 score of 6-7(high-risk of ischemic stroke)(P<0.05).For predicting the short-term incidence of ischemic stroke after TIA,the AUC of ABCD2 score was 0.778(95%CI(0.671,0.886),the cut-off value was 4.5,sensitivity was 72.0%,specificity was 72.2%),the AUC of chemokine CXCL12 was 0.909(95%CI(0.850,0.968),the cut-off value was 9.6? g/L,sensitivity was 76.0%,specificity was 91.1%),the AUC of sVCAM-1 was 0.875(95%CI(0.781,0.968),the cut-off value was 682.7? g/L,sensitivity was 84.0%,specificity was 87.3%);he AUC of chemokine CXCL12 combined with sVCAM-1 was 0.878(95%CI(0.799,0.956),the cut-off values were 9.6? g/L and 682.7? g/L,sensitivity was 92.0%,specificity was 83.5%.Conclusion:Both chemokine CXCL12 and sVCAM-1 are important biological markers for predicting the short-term incidence of ischemic stroke in patients after TIA,which deserve to be widely used in clinical practice.