Serum ADAMTS18 Levels at Admission Are Associated With 3-Month Functional Outcome After Acute Ischemic Stroke

AIMS: ADAMTS18 is a secreted metalloproteinase implicated in vascular homeostasis and protection against ischemic brain injury. However, its clinical relevance in acute ischemic stroke (AIS) remains unclear. METHODS: We retrospectively analyzed 194 AIS patients from the Chengdu Stroke Registry. Serum ADAMTS18 levels were measured within 48 hours of admission using ELISA. Associations between ADAMTS18 levels and 3-month poor outcomes (modified Rankin Scale score 3-6) were evaluated using logistic regression. Predictive performance was assessed using area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). RESULTS: ＜0.001). Incorporating ADAMTS18 into predictive models improved discrimination (AUC = 0.91 vs. 0.86, P = 0.011), IDI (11.14%, P＜0.001), and NRI (77.1%, P＜0.001). CONCLUSION: Lower admission ADAMTS18 levels are independently associated with poor 3-month functional outcomes after AIS and may provide additional prognostic information.