Prognostic Significance Of Plasma CLEC-2 In Patients With Acute Ischemic Stroke

Objective:C-type lectin-like receptor 2(CLEC-2)is a platelet surface receptor that highly mediates platelet aggregation and activation,which was increased in coronary heart disease,given the connections between coronary heart disease and ischemic stroke,this study aimed to analyzed the relationship between CLEC-2 level with stroke progression and long-term prognosis in patients with acute cerebral infarction.Methods:352 patients with acute cerebral infarction were collected continuously from the Second Affiliated Hospital of Suzhou University from December 2016 to December 2017,and 112 health examination people without cerebral infarction,coronary heart disease and peripheral vascular disease were enrolled as control group.Patients with acute cerebral infarction collected and recorded the general clinical data,laboratory indicators,imaging examinations and etc.Patients with acute cerebral infarction were scored by the National Institutes of Health Stroke Scale(NIHSS)to assess neurological impairment,and use Modified Rankin scale(mRS)to evaluate the self-care ability of patients in daily life for 3 months after discharge.Compare plasma CLEC-2 levels between acute cerebral infarction group and healthy control group,and to analyze the relativity between CLEC-2 level and stroke progression.ROC curve was used to analyze the predictive effect of CLEC-2 for stroke progression.According to the mRS scores,the patients were divided into the good outcome subgroup and the poor outcome subgroup,and to analyze the relativity between CLEC-2 level and prognosis 90 days after discharge.ROC curve was used to evaluate the predictive effect of CLEC-2 for poor prognosis after 90 days of onset.Results:Patients with acute cerebral infarction had a significantly higher plasma CLEC-2 level compared to healthy controls(177.68±91.83pg/ml vs.106.7±72.64pg/ml,P<0.05).Patients with poor prognosis had a significantly higher plasma CLEC-2 level compared to good prognosis(201.39±104.29pg/ml vs.168.14±84.67pg/ml,P=0.005).According to the CLEC-2 quartile,the patients were divided into four groups:<110pg/ml,110-157pg/ml,157-237pg/ml,and>237pg/ml,and after adjusting for potential confounders,the risk of stroke progression in the high CLEC-2 level(>237pg/ml)group was 7.69 times higher than that in the low CLEC-2 level(<110pg/ml)group(95%Cl:1.43-41.41),the risk of poor prognosis in the high CLEC-2 level(>237pg/ml)group was increased 4.58 times than that in the low CLEC-2 level(<110pg/ml)group(95%CI:1.76-17.68).The optimal cutoff point of CLEC-2 for predicting stroke progression was 235.48pg/mL from Youden index,with specificity of 54.2%,sensitivity of 76.8%.The optimal cutoff point of pCLEC-2 for predicting stroke prognosis was 207.08pg/mL from Youden index,with specificity of 48.5%,sensitivity of 71.7%.Conclusion:1)Patients with acute cerebral infarction had a significantly higher plasma CLEC-2 level compared to healthy controls.2)Increased plasma CLEC-2 levels was associated with stroke progression and poor prognosis,which suggested that CLEC-2 may be one of the important biological markers for evaluating the condition and prognosis of acute cerebral infarction.