High plasma thrombomodulin level is associated with a decreased risk of cognitive impairment after ischemic stroke
•High plasma thrombomodulin levels were associated with a decreased risk of PSCI.•Thrombomodulin could significantly improve the risk reclassification of PSCI.•Plasma thrombomodulin might be a predictive biomarker target for PSCI. Thrombomodulin, a thrombin receptor with anticoagulant, anti-inflamma...
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| Veröffentlicht in: | Journal of stroke and cerebrovascular diseases 2025-01, Vol.34 (1), p.108172, Article 108172 |
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| container_title | Journal of stroke and cerebrovascular diseases |
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| creator | He, Yu Chang, Xinyue Liu, Yi Fei, Jiawen Qin, Xiaoli Song, Beiping Yu, Quan Shi, Mengyao Guo, Daoxia Chen, Jing Wang, Aili Xu, Tan He, Jiang Zhang, Yonghong Zhu, Zhengbao |
| description | •High plasma thrombomodulin levels were associated with a decreased risk of PSCI.•Thrombomodulin could significantly improve the risk reclassification of PSCI.•Plasma thrombomodulin might be a predictive biomarker target for PSCI.
Thrombomodulin, a thrombin receptor with anticoagulant, anti-inflammatory, and cytoprotective properties, has been suggested to play a pivotal role in ischemic stroke. However, the association of plasma thrombomodulin with post-stroke cognitive impairment (PSCI) remains unclear. We aimed to prospectively investigate the associations of plasma thrombomodulin with PSCI among ischemic stroke patients in a multicenter cohort study.
We measured plasma thrombomodulin levels at baseline among 615 ischemic stroke patients from a preplanned ancillary study of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). We used Montreal Cognitive Assessment (MoCA) to evaluate cognitive function at 3-month follow-up after ischemic stroke, and PSCI was defined as MoCA score |
| doi_str_mv | 10.1016/j.jstrokecerebrovasdis.2024.108172 |
| format | Article |
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Thrombomodulin, a thrombin receptor with anticoagulant, anti-inflammatory, and cytoprotective properties, has been suggested to play a pivotal role in ischemic stroke. However, the association of plasma thrombomodulin with post-stroke cognitive impairment (PSCI) remains unclear. We aimed to prospectively investigate the associations of plasma thrombomodulin with PSCI among ischemic stroke patients in a multicenter cohort study.
We measured plasma thrombomodulin levels at baseline among 615 ischemic stroke patients from a preplanned ancillary study of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). We used Montreal Cognitive Assessment (MoCA) to evaluate cognitive function at 3-month follow-up after ischemic stroke, and PSCI was defined as MoCA score <23.
Plasma thrombomodulin was inversely associated with PSCI, and the adjusted odds ratio of PSCI for the highest versus lowest quartile of thrombomodulin was 0.50 (95 % CI: 0.28-0.92, Ptrend=0.026). Each standard deviation increment of log-transformed thrombomodulin was associated with a 23 % (odds ratio: 0.77, 95 % CI: 0.62-0.97, P=0.029) decreased risk of PSCI. In addition, plasma thrombomodulin could significantly improve the risk reclassification of PSCI beyond established risk factors (net reclassification index: 25.04 %, 95 % CI: 7.20 %-42.87 %, P=0.007; integrated discrimination improvement: 1.13 %, 95 % CI: 0.18 %-2.09 %, P=0.020).
High plasma thrombomodulin levels were associated with a decreased risk of PSCI among ischemic stroke patients. Our findings suggest that plasma thrombomodulin might be a predictive biomarker and potential therapeutic target for PSCI.</description><identifier>ISSN: 1052-3057</identifier><identifier>ISSN: 1532-8511</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2024.108172</identifier><identifier>PMID: 39631512</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Biomarker ; Cognitive impairment ; Ischemic stroke ; Prognosis ; Thrombomodulin</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2025-01, Vol.34 (1), p.108172, Article 108172</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c269t-de27a024063c52fb8704e67e3c2d852b53c4bc31f22557b3a6a63ea698d30f203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2024.108172$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39631512$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>He, Yu</creatorcontrib><creatorcontrib>Chang, Xinyue</creatorcontrib><creatorcontrib>Liu, Yi</creatorcontrib><creatorcontrib>Fei, Jiawen</creatorcontrib><creatorcontrib>Qin, Xiaoli</creatorcontrib><creatorcontrib>Song, Beiping</creatorcontrib><creatorcontrib>Yu, Quan</creatorcontrib><creatorcontrib>Shi, Mengyao</creatorcontrib><creatorcontrib>Guo, Daoxia</creatorcontrib><creatorcontrib>Chen, Jing</creatorcontrib><creatorcontrib>Wang, Aili</creatorcontrib><creatorcontrib>Xu, Tan</creatorcontrib><creatorcontrib>He, Jiang</creatorcontrib><creatorcontrib>Zhang, Yonghong</creatorcontrib><creatorcontrib>Zhu, Zhengbao</creatorcontrib><title>High plasma thrombomodulin level is associated with a decreased risk of cognitive impairment after ischemic stroke</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>•High plasma thrombomodulin levels were associated with a decreased risk of PSCI.•Thrombomodulin could significantly improve the risk reclassification of PSCI.•Plasma thrombomodulin might be a predictive biomarker target for PSCI.
Thrombomodulin, a thrombin receptor with anticoagulant, anti-inflammatory, and cytoprotective properties, has been suggested to play a pivotal role in ischemic stroke. However, the association of plasma thrombomodulin with post-stroke cognitive impairment (PSCI) remains unclear. We aimed to prospectively investigate the associations of plasma thrombomodulin with PSCI among ischemic stroke patients in a multicenter cohort study.
We measured plasma thrombomodulin levels at baseline among 615 ischemic stroke patients from a preplanned ancillary study of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). We used Montreal Cognitive Assessment (MoCA) to evaluate cognitive function at 3-month follow-up after ischemic stroke, and PSCI was defined as MoCA score <23.
Plasma thrombomodulin was inversely associated with PSCI, and the adjusted odds ratio of PSCI for the highest versus lowest quartile of thrombomodulin was 0.50 (95 % CI: 0.28-0.92, Ptrend=0.026). Each standard deviation increment of log-transformed thrombomodulin was associated with a 23 % (odds ratio: 0.77, 95 % CI: 0.62-0.97, P=0.029) decreased risk of PSCI. In addition, plasma thrombomodulin could significantly improve the risk reclassification of PSCI beyond established risk factors (net reclassification index: 25.04 %, 95 % CI: 7.20 %-42.87 %, P=0.007; integrated discrimination improvement: 1.13 %, 95 % CI: 0.18 %-2.09 %, P=0.020).
High plasma thrombomodulin levels were associated with a decreased risk of PSCI among ischemic stroke patients. Our findings suggest that plasma thrombomodulin might be a predictive biomarker and potential therapeutic target for PSCI.</description><subject>Biomarker</subject><subject>Cognitive impairment</subject><subject>Ischemic stroke</subject><subject>Prognosis</subject><subject>Thrombomodulin</subject><issn>1052-3057</issn><issn>1532-8511</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNqVkE1rGzEQhkVJaD7av1B0LIF19GFp18cmNB9gyCU9C600G8tZrVyN7NB_X4VNesqlpxmGh3dmHkIuOFtwxvXldrHFktMzOMjQ53Sw6AMuBBPLCnS8FZ_IKVdSNJ3i_Kj2TIlGMtWekDPELWOcq059JidypSVXXJySfBeeNnQ3WoyWlk1OsU8x-f0YJjrCAUYakFrE5IIt4OlLKBtqqQeXwWId5IDPNA3UpacplHAAGuLOhhxhKtQOBXJNcBuIwdH5-i_keLAjwte3ek5-3fx8vL5r1g-399c_1o0TelUaD6K19TWmpVNi6LuWLUG3IJ3wnRK9km7ZO8kHIZRqe2m11RKsXnVeskEweU6-z7m7nH7vAYuJ9RIYRztB2qORfKkVb1utK3o1oy4nxAyD2eUQbf5jODOv7s3WfOTevLo3s_sa8u1t376P4P9FvMuuwHoGoH59CJANugCTAx8yuGJ8Cv-z7y9T3aWo</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>He, Yu</creator><creator>Chang, Xinyue</creator><creator>Liu, Yi</creator><creator>Fei, Jiawen</creator><creator>Qin, Xiaoli</creator><creator>Song, Beiping</creator><creator>Yu, Quan</creator><creator>Shi, Mengyao</creator><creator>Guo, Daoxia</creator><creator>Chen, Jing</creator><creator>Wang, Aili</creator><creator>Xu, Tan</creator><creator>He, Jiang</creator><creator>Zhang, Yonghong</creator><creator>Zhu, Zhengbao</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20250101</creationdate><title>High plasma thrombomodulin level is associated with a decreased risk of cognitive impairment after ischemic stroke</title><author>He, Yu ; Chang, Xinyue ; Liu, Yi ; Fei, Jiawen ; Qin, Xiaoli ; Song, Beiping ; Yu, Quan ; Shi, Mengyao ; Guo, Daoxia ; Chen, Jing ; Wang, Aili ; Xu, Tan ; He, Jiang ; Zhang, Yonghong ; Zhu, Zhengbao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c269t-de27a024063c52fb8704e67e3c2d852b53c4bc31f22557b3a6a63ea698d30f203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Biomarker</topic><topic>Cognitive impairment</topic><topic>Ischemic stroke</topic><topic>Prognosis</topic><topic>Thrombomodulin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>He, Yu</creatorcontrib><creatorcontrib>Chang, Xinyue</creatorcontrib><creatorcontrib>Liu, Yi</creatorcontrib><creatorcontrib>Fei, Jiawen</creatorcontrib><creatorcontrib>Qin, Xiaoli</creatorcontrib><creatorcontrib>Song, Beiping</creatorcontrib><creatorcontrib>Yu, Quan</creatorcontrib><creatorcontrib>Shi, Mengyao</creatorcontrib><creatorcontrib>Guo, Daoxia</creatorcontrib><creatorcontrib>Chen, Jing</creatorcontrib><creatorcontrib>Wang, Aili</creatorcontrib><creatorcontrib>Xu, Tan</creatorcontrib><creatorcontrib>He, Jiang</creatorcontrib><creatorcontrib>Zhang, Yonghong</creatorcontrib><creatorcontrib>Zhu, Zhengbao</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of stroke and cerebrovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>He, Yu</au><au>Chang, Xinyue</au><au>Liu, Yi</au><au>Fei, Jiawen</au><au>Qin, Xiaoli</au><au>Song, Beiping</au><au>Yu, Quan</au><au>Shi, Mengyao</au><au>Guo, Daoxia</au><au>Chen, Jing</au><au>Wang, Aili</au><au>Xu, Tan</au><au>He, Jiang</au><au>Zhang, Yonghong</au><au>Zhu, Zhengbao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High plasma thrombomodulin level is associated with a decreased risk of cognitive impairment after ischemic stroke</atitle><jtitle>Journal of stroke and cerebrovascular diseases</jtitle><addtitle>J Stroke Cerebrovasc Dis</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>34</volume><issue>1</issue><spage>108172</spage><pages>108172-</pages><artnum>108172</artnum><issn>1052-3057</issn><issn>1532-8511</issn><eissn>1532-8511</eissn><abstract>•High plasma thrombomodulin levels were associated with a decreased risk of PSCI.•Thrombomodulin could significantly improve the risk reclassification of PSCI.•Plasma thrombomodulin might be a predictive biomarker target for PSCI.
Thrombomodulin, a thrombin receptor with anticoagulant, anti-inflammatory, and cytoprotective properties, has been suggested to play a pivotal role in ischemic stroke. However, the association of plasma thrombomodulin with post-stroke cognitive impairment (PSCI) remains unclear. We aimed to prospectively investigate the associations of plasma thrombomodulin with PSCI among ischemic stroke patients in a multicenter cohort study.
We measured plasma thrombomodulin levels at baseline among 615 ischemic stroke patients from a preplanned ancillary study of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). We used Montreal Cognitive Assessment (MoCA) to evaluate cognitive function at 3-month follow-up after ischemic stroke, and PSCI was defined as MoCA score <23.
Plasma thrombomodulin was inversely associated with PSCI, and the adjusted odds ratio of PSCI for the highest versus lowest quartile of thrombomodulin was 0.50 (95 % CI: 0.28-0.92, Ptrend=0.026). Each standard deviation increment of log-transformed thrombomodulin was associated with a 23 % (odds ratio: 0.77, 95 % CI: 0.62-0.97, P=0.029) decreased risk of PSCI. In addition, plasma thrombomodulin could significantly improve the risk reclassification of PSCI beyond established risk factors (net reclassification index: 25.04 %, 95 % CI: 7.20 %-42.87 %, P=0.007; integrated discrimination improvement: 1.13 %, 95 % CI: 0.18 %-2.09 %, P=0.020).
High plasma thrombomodulin levels were associated with a decreased risk of PSCI among ischemic stroke patients. Our findings suggest that plasma thrombomodulin might be a predictive biomarker and potential therapeutic target for PSCI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39631512</pmid><doi>10.1016/j.jstrokecerebrovasdis.2024.108172</doi><oa>free_for_read</oa></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Biomarker Cognitive impairment Ischemic stroke Prognosis Thrombomodulin |
| title | High plasma thrombomodulin level is associated with a decreased risk of cognitive impairment after ischemic stroke |
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