Abstract WMP73: Extracellular Newly Identified Receptor for Advanced Glycation End Products Binding Protein Predicts the Outcome in Patients with Acute Ischemic Stroke: Research for Biomarkers in Ischemic Stroke

Abstract

Background: Extracellular newly identified receptor for advanced glycation end products binding protein (EN-RAGE) contributes to inflammation and is associated with poor outcome after ischemic heart disease. We assessed the plasma EN-RAGE levels in acute stroke patients and examined their relation with functional outcome after stroke. Methods: Blood samples and clinical information were obtained from 171 patients with ischemic stroke at 5 points (days 0, 3, 7,14, and 90) after the onset. Age- and sex-matched healthy 171 controls were enrolled from the Hisayama study in Japan. Stroke severity was assessed with the National Institute of Health Stroke Score (NIHSS). Functional outcome at 90 days was assessed by modified Rankin scale (mRS). To analyze the effects of EN-RAGE levels on stroke severity and outcome, patients were divided into high and low EN-RAGE groups according to whether the level was above or below the median of the whole patients at day 0. Results: EN-RAGE levels at day 0 were higher in patients [1.6 (0.8-3.5), median (IQR)] than in controls [0.9 (0.4-1.6)] (p<0.01). Patients with poor outcome (mRS: 2-6, n=73) showed higher EN-RAGE levels at day 0 [2.1 (1.2-5.1)] than those with good outcome (mRS: 0-1, n=97) [1.1 (0.5-2.0)] (p<0.01). Multivariate analysis revealed that EN-RAGE levels at day 0 independently associated with poor outcome (OR:1.2, 95%CI: 1.1-1.5). Although NIHSS were not different between high (n=87) and low (n=84) EN-RAGE groups at day 0 [4 (2-8) vs 4 (2-6)], low EN-RAGE group showed significantly lower NIHSS than high EN-RAGE group at days 3, 7, 14, and 90. Low EN-RAGE group showed preferable outcome than high EN-RAGE group (figure). Conclusions: Our study suggests that EN-RAGE predicts poor outcome in patients with acute ischemic stroke.