Keywords
cerebral stroke
carotid stenosis
atherosclerosis biomarkers
How to Cite
Abstract
In press
Background. Atherosclerosis of large arteries is the cause of a significant portion of Ischemic Strokes (IS) and the degree of Extracranial Carotid Stenosis (ECS) remains the main marker for stratifying the risk of IS.
Aim. To determine the diagnostic and prognostic value of P-selectin in patients with ischemic stroke and extracranial carotid artery stenosis of different degrees.
Materials and Methods. 100 patients with IS due to carotid atherosclerosis were divided into 2 groups: 50 patients with stenotic carotid atherosclerosis (stenosis >50%), including 31 men and 19 women (31/19) with average age [67.8±8.7] years; 50 – with stenosis <50% (men/women – 29/21, average age [63.9±9.4] years). Control group – 20 clinically healthy individuals (men/women – 11/9, average age [60.8±7.9] years). Research methods: assessment of stroke severity according to the National Institutes of Health Stroke Scale (NIHSS), assessment of functional deficit according to the modified Rankin scale, serum P-selectin level by enzyme-linked immunosorbent assay. Statistical analysis – by parametric and non-parametric methods using Statistica 8.0 (Statsoft, USA) at a critical p-level of 0.05. The study is a part of the dissertation research of the second author.
Research Ethics. The study was conducted in compliance with the principles of the World Medical Association Declaration of Helsinki (1964–2024), Order of the Ministry of Health of Ukraine No.690 dated 09/23/2009, and the conclusion of the Bioethics Commission of the Kharkiv Medical Academy of Postgraduate Education No.1 dated 02/18/2020. All participants provided written informed consent to participate in the study.
Results. The level of P-selectin in the blood serum showed an intergroup heterogeneity and was the highest in patients with stenosing ECS – [39.41±4.46] ng/ml, in non-stenosing – [26.92±6.01] ng/ml (p<0.001). In the group of non-stenosing ECS, the content of P-selectin was lower by 12.49 ng/ml, or by 46.4% compared with the stenosing ECS. The control group had the lowest values – [24.07±6.30] ng/ml, but there was no significant difference with the group of non-stenosing ECS (p=0.095). The level of P-selectin did not correlate with the severity of neurological deficit and functional status of patients with IS.
Conclusions. P-selectin levels are significantly higher in IS patients with stenotic ECS compared to nonstenotic ECS, supporting the role of P-selectin as a marker of active platelet-endothelial interaction in progressive atherosclerotic lesions.
Keywords: neurology, cerebral stroke, carotid stenosis, atherosclerosis biomarkers.
References
McEver RP. Selectins: initiators of leucocyte adhesion and signalling at the vascular wall. Cardiovasc Res. 2015;107(3):331-9. DOI: 10.1093/cvr/cvv154. PMID: 25994174.
Koyama H, Maeno T, Fukumoto S, Shoji T, Yamane T, Yokoyama H, et al. Platelet P-selectin expression is associated with atherosclerotic wall thickness in carotid artery in humans. Circulation. 2003;108(5):524-9. DOI: 10.1161/01.CIR.0000081765.88440.51. PMID: 12860908.
Yang X-L, Zhu D-S, Lv H-H, Huang X-X, Han Y, Wu S, et al. Etiological Classification of Cerebral Ischemic Stroke by the TOAST, SSS-TOAST, and ASCOD Systems: The Impact of Observer’s Experience on Reliability. Neurologist. 2019;24(4):111-4. DOI: 10.1097/NRL.0000000000000236. PMID: 31246719.
Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke. 2022;17(1):18-29. DOI: 10.1177/17474930211065917. PMID: 34986727.
Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update from the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021. DOI: 10.1016/j.jacc.2020.11.010. PMID: 33309175.
Theofilis P, Sagris M, Oikonomou E, Antonopoulos AS, Siasos G, Tsioufis C, et al. Inflammatory Mechanisms Contributing to Endothelial Dysfunction. Biomedicines. 2021;9(7):781. DOI: 10.3390/biomedicines9070781. PMID: 34356845.
Li N, Pi C, Zhu S, Li X, Wang L, Shi P, et al. Opportunities for the treatment of atherosclerosis: Selectins. Pharmacol Res. 2025;217:107807. DOI: 10.1016/j.phrs.2025.107807. PMID: 40449813.
Sommer P, Schreinlechner M, Noflatscher M, Lener D, Mair F, Theurl M, et al. Increasing Soluble P-Selectin Levels Predict Higher Peripheral Atherosclerotic Plaque Progression. J Clin Med. 2023;12(20):6430. DOI: 10.3390/jcm12206430. PMID: 37892568.
Tscharre M, Vogel B, Tentzeris I, Freynhofer MK, Rohla M, Wojta J, et al. Prognostic Impact of Soluble P-Selectin on Long-Term Adverse Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention. Thromb Haemost. 2019;119(2):340-7. DOI: 10.1055/s-0038-1676563. PMID: 30593084.
Hahn W, Tsalouchidou PE, Nagels A, Straube B. Neural activation during natural speech and rests in patients with schizophrenia and schizophrenia spectrum disorders - an fMRI pilot trial. Front Psychiatry. 2024;15:1402818. DOI: 10.3389/fpsyt.2024.1402818. PMID: 38938468.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.