Adham Mahmoud Mohamad Ismail, Sawsan Abd El Aziz Youssef, Ahmed El Sayed Badawy, Rania Yehia ‎Helal Mohamed

Abstract

Cerebrovascular ischemic stroke is one of the key neurological diseases. Its myriad of risk factors and complexity of pathogenesis keep the door open for new biomarkers to be studied. Cystatin C is a sensitive biomarker of preclinical renal dysfunction. There is a correlation between the vascular disease of the kidney and brain, so cystatin C is considered as an important biomarker for acute ischemic stroke. We assessed the correlation of cystatin C serum levels with vascular risk factors, clinical severity, and short term outcome of first-ever acute ischemic stroke. In this prospective cohort study, we included 174 adult patients with first-ever acute cerebrovascular ischemic stroke of not more than 48 hours duration with normal kidney functions (78 males and 96 females with age ranged from 33 to 90 years). Serum cystatin C was determined by enzyme-linked immunosorbent assay. All patients were followed up for one week to detect a short-term outcome. Cystatin C serum level had a statistically significant positive relationship with some vascular risk factors such as diabetes mellitus, dyslipidemia, and atrial fibrillation. Cystatin C serum level tended to be positively associated with the national institutes of health stroke scale (NIHSS) at admission. Higher scores of NIHSS indicating more severe neurological impairment were correlated with higher mean levels of serum cystatin C with a p < 0.01. There was highly statistically significant correlation between cystatin C serum level and outcome of the investigated patients. It was highest in the patient group with a poor outcome (p < 0.001). Serum cystatin C is an indicator of severe neurological impairment and prognostic biomarker for poor outcome‎.