Outcome of Ischemic Stroke at Six Months with Neuroglobin as a Marker

Background: Prognostic markers can optimize the management of acute ischemic stroke (AIS). Neuroglobin (Ngb), which plays a role in intraneuronal oxygen transport and hypoxia resistance, is a potential prognostic marker in AIS. Methods: A cohort study was conducted on patients with AIS treated at Dr. Cipto Mangunkusumo National Referral Hospital from March to April 2023. Serum samples for Ngb examination were collected three days after the onset of the stroke, while a modified Rankin Scale (mRS) was obtained after seven days and again after six months. National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), and Montreal Cognitive Assessment (MoCA-Ina) scores were obtained on the seventh day. Significance analysis and receiver operating characteristic (ROC) curve were used to determine the relationship between Ngb and AIS outcomes. Results: A total of 42 subjects underwent analysis. Serum Ngb levels were higher in subjects with mRS score of 3 to 6, compared to those with scores of 0 to 2 (median [range]: 12.42ng/mL [3.57-50.43] vs. 4.79ng/mL [2.25-37.32], p=0.005). The association with mRS persisted until six months post-AIS (p=0.004). The area under the ROC curve (AUC) was 0.75. Ngb levels were also higher in groups with higher NIHSS at discharge (p=0.03), lower BI (p=0.01), and lower MoCA-Ina scores (p=0.002). Clinical assessments (BI and NIHSS), along with evaluations of cognitive function and Ngb markers, can be employed to monitor patient progress and predict stroke outcomes up to six-months post-AIS. Conclusion: Higher serum Ngb levels in AIS are associated with poorer functional outcomes. Further research is needed before clinical application.