Serum Human epididymal protein 4 as a predictor of adverse events in acute ischemic stroke patients receiving antiplatelet therapy

Acute kidney injury (AKI) frequently develops in certain patients with acute ischemic stroke (AIS) and often indicates a poor prognosis. However, the relationship between serum human epididymal protein 4 (HE4), a newly recognized biomarker of renal injury, and adverse outcomes in AIS patients remains unclear. This study aimed to investigate the prognostic value of admission serum HE4 levels for predicting unfavorable outcomes in AIS patients undergoing antiplatelet therapy. We conducted a cohort study involving 144 consecutive adult patients admitted for AIS who received antiplatelet treatment. Blood samples were collected after admission to measure serum HE4 concentrations. Serum HE4 levels were markedly elevated in AIS patients on antiplatelet therapy compared with healthy controls (116.4 ± 24.8 pmol/L vs. 25.3 ± 9.8 pmol/L). Kaplan–Meier analysis revealed that higher HE4 levels were associated with an increased incidence of cardiovascular events and/or recurrent stroke. Multivariate Cox regression analysis indicated that elevated HE4 concentrations independently predicted a higher risk of cardiovascular events (HR = 3.02; 95% CI: 1.51–6.29; P = 0.01) and stroke recurrence (HR = 3.81; 95% CI: 1.64–6.63; P < 0.01). Elevated serum HE4 levels are significantly associated with a heightened risk of cardiovascular events and recurrent stroke in AIS patients receiving antiplatelet therapy, suggesting that HE4 may serve as a potential biomarker for predicting adverse outcomes in this population.