Key result
Changes in HDL proteins during the early acute phase of stroke significantly correlated with functional recovery scores at 3 months (R2=0.38-0.73, adjusted P<0.05).
Why the study?
Prospective cohort studies question the value of HDL-C for stroke risk prediction, prompting investigation into the relationship between long-term functional recovery and the HDL proteome and function.
Do changes in HDL protein composition and function correlate with functional recovery in patients after acute ischemic stroke?
Observational (n=70)
Do changes in HDL protein composition and function correlate with functional recovery in patients after acute ischemic stroke?
Effect estimate: R2=0.38-0.73
p-value: p=<0.05
Changes in HDL protein composition during the early acute phase of ischemic stroke correlate with functional recovery at 3 months, suggesting their potential as clinical biomarkers.
May flag HDL proteins as recovery biomarkers post-stroke; leaves open causal roles and clinical utility pending validation.
Rationale: Prospective cohort studies question the value of HDL-C (high-density lipoprotein cholesterol) for stroke risk prediction. Objective: Investigate the relationship between long-term functional recovery and HDL proteome and function. Methods and Results: Changes in HDL protein composition and function (cholesterol efflux capacity) in patients after acute ischemic stroke at 2 time points (24 hours, 35 patients; 96 hours, 20 patients) and in 35 control subjects were measured. The recovery from stroke was assessed by 3 months, the National Institutes of Health Stroke Scale and modified Rankin scale scores. When compared with control subject after adjustments for sex and HDL-C levels, 12 proteins some of which participate in acute phase response and platelet activation (APMAP [adipocyte plasma membrane-associated protein], GPLD1 [phosphate inositol-glycan specific phospholipase D], APOE [apolipoprotein E], IHH [Indian hedgehog protein], ITIH4 [inter-alpha-trypsin inhibitor chain H4], SAA2 [serum amyloid A2], APOA4 [apolipoprotein A-IV], CLU [clusterin], ANTRX2 [anthrax toxin receptor 2], PON1 [serum paraoxonase/arylesterase], SERPINA1 [alpha-1-antitrypsin], and APOF [apolipoprotein F]) were significantly (adjusted P <0.05) altered in stroke HDL at 96 hours. The first 8 of these proteins were also significantly altered at 24 hours. Consistent with inflammatory remodeling, cholesterol efflux capacity was reduced by 32% ( P <0.001) at both time points. Baseline stroke severity adjusted regression model showed that changes within 96-hour poststroke in APOF, APOL1, APMAP, APOC4 (apolipoprotein C4), APOM (apolipoprotein M), PCYOX1 (prenylcysteine oxidase 1), PON1, and APOE correlate with stroke recovery scores ( R 2 =0.38–0.73, adjusted P <0.05). APOF ( R 2 =0.73) and APOL1 ( R 2 =0.60) continued to significantly correlate with recovery scores after accounting for tPA (tissue-type plasminogen activator) treatment. Conclusions: Changes in HDL proteins during early acute phase of stroke associate with recovery. Monitoring HDL proteins may provide clinical biomarkers that inform on stroke recuperation.
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Plubell et al. (2020) conducted an observational in Acute ischemic stroke (n=70). Acute ischemic stroke vs. Control subjects was evaluated on Correlation of HDL protein changes with stroke recovery scores (NIHSS and modified Rankin scale) at 3 months (R2=0.38-0.73, p=<0.05). Changes in HDL proteins during the early acute phase of stroke significantly correlated with functional recovery scores at 3 months (R2=0.38-0.73, adjusted P<0.05).
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