ISSN : 2146-3123
E-ISSN : 2146-3131

The Diagnostic Value of Stweak in Acute Ischemic Stroke
Ertan Comertpay1, Sevilay Vural2, Oğuz Eroğlu1, Nermin Dindar Badem3, Yasemin Bilgili4, Figen Coskun1
1Department of Emergency, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey
2Department of Emergency, Bozok University Faculty of Medicine, Yozgat, Turkey
3Department of Clinical Biochemistry, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey
4Department of Radyology Kırıkkale University, Faculty of Medicine, Kırıkkale, Turkey
DOI : 10.4274/balkanmedj.galenos.2020.2020.2.45

Background: Considering the critical role of early diagnosis and management of acute ischemic stroke (AIS), there is still a need for biomarkers that would reliably assist. The expected features of a reliable stroke biomarker should include rapid analysis, high specificity for brain damage, and availability in the emergency settings for early diagnosis as well as exclusion from other conditions that mimic AIS. Being a protein involved in the regulation of several biological functions, soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) could be a potential biomarker of AIS.
Aims: This study aimed to investigate the diagnostic value of sTWEAK in AIS patients, and to examine the relationship between ischemic area volume (IAV) determined at Diffusion-Weighted Magnetic Resonance Imaging (DWI) and sTWEAK.
Study Design: Prospective, case-control study.
Methods: Participants of this case-control prospective study were AIS patients and healthy volunteers. Information on age, sex, presence of chronic disease, neurological examination findings, times of presentation to the emergency department after AIS, sTWEAK levels, IAVs at DWI, and 6-month mortality rates after stroke were recorded. The results were analyzed on SPSS 22.0 software, and p values < 0.05 were considered as statistically significant.
Results: Thirty-six patients with AIS and 36 healthy volunteers were included in the study. A sTWEAK cut-off value of 995.5 pg/ml exhibited sensitivity of 80.5% and a positive predictive value of 82.5% with Area Under Curve: 0.84 (95% CI: 0.74-0.94; p < 0.001). The mean sTWEAK levels were significantly higher in the AIS group (1968.08 ± 1441.99 μg/L) than the control group (704.81 ± 291.72 μg/L) (p < 0.001). No correlation was observed between sTWEAK levels, and IAV measured at DWI (r: -0.008; p = 0.07). The mean IAV was 505.68 ± 381.10 mm3 in the non-surviving patients and 60.96 ± 80.89 mm3 in the surviving patients (p = 0.002).
Conclusion: sTWEAK can be used in the diagnosis of AIS. However, it is inconclusive in estimating IAV and early mortality following AIS. IAV measured at DWI is a marker of poor prognosis and can be used in predicting early mortality.

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