Key result
The highest tertile of plasma ANGPTL-4 concentrations was associated with a 59% increased odds of death or major disability at 3 months compared to the lowest tertile in patients with acute ischemic stroke (OR 1.59).
Why the study?
ANGPTL-4 was known to be associated with ischemic stroke risk, but its prognostic value remained unclear.
Does higher baseline plasma ANGPTL-4 concentration predict an increased risk of death or major disability in acute ischemic stroke patients?
Cohort (n=3,379)
Yes
Does higher baseline plasma ANGPTL-4 concentration predict an increased risk of death or major disability in acute ischemic stroke patients?
Odds Ratio: 1.59 (95% CI 1.22–2.06)
Absolute Event Rate: 36.3% vs 14.4%
p-value: p=<0.001
Higher baseline plasma ANGPTL-4 concentrations are independently associated with an increased risk of death or major disability at 3 months in patients with acute ischemic stroke, suggesting its potential as a prognostic biomarker.
May aid post-stroke risk stratification; leaves open whether ANGPTL-4 improves prediction beyond standard models.
AIMS: Angiopoietin-like protein 4 (ANGPTL-4) had been reported to be associated with the risk of ischemic stroke, but its prognostic value remained unclear. The aim of this study was to investigate the association between plasma ANGPTL-4 concentrations and prognosis of ischemic stroke. METHODS: Baseline plasma ANGPTL-4 concentrations were measured in 3379 acute ischemic stroke patients. The primary outcome was a combination of death or major disability (modified Rankin Scale score, ≥3) at 3 months after ischemic stroke. RESULTS: At 3 months after ischemic stroke, 850 (26.16%) participants experienced major disability or died (750 major disabilities and 100 deaths). After adjusting for important covariates, odds ratios for the highest tertile of plasma ANGPTL-4 concentrations were 1.59 (1.22-2.06) for primary outcome, 1.53 (1.18-1.97) for major disability, and 2.03 (1.03-4.00) for death when compared with the lowest tertile of plasma ANGPTL-4 concentrations. For 1-SD increase in log-ANGPTL-4 concentrations (0.44 ng/mL), the adjusted odds ratios were 1.24 (1.11-1.38), 1.14 (1.03-1.27), and 1.72 (1.32-2.23), respectively. Adding ANGPTL-4 to a model containing conventional risk factors improved risk prediction for composite outcome of death and major disability. CONCLUSION: Higher plasma ANGPTL-4 concentration was associated with poor prognosis in acute ischemic stroke patients, suggesting that ANGPTL-4 might be a prognostic marker for ischemic stroke.
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Zheng et al. (2021) conducted a cohort in Acute ischemic stroke (n=3,379). Plasma ANGPTL-4 concentrations vs. Lowest tertile of plasma ANGPTL-4 concentrations (<78.7 ng/mL) was evaluated on Composite of death or major disability (modified Rankin Scale score ≥3) at 3 months (OR 1.59, 95% CI 1.22-2.06, p=<0.001). The highest tertile of plasma ANGPTL-4 concentrations was associated with a 59% increased odds of death or major disability at 3 months compared to the lowest tertile in patients with acute ischemic stroke (OR 1.59).
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