Systemic CXCL4 Levels and Clinical Outcomes in Acute Ischemic Stroke

Platelet activation within the intravascular ischemic compartment, as indicated by elevated CXCL4 levels, has been implicated in the pathogenesis of acute ischemic stroke (AIS). Based on this, the prognostic value of venous CXCL4 concentrations measured within 24 hours of stroke onset was investigated.

A total of 111 patients with moderate to severe AIS (NIHSS score ≥6 and/or an indication for mechanical recanalization) were enrolled in this prospective, single-center study. Plasma CXCL4 levels were measured using ELISA. Functional outcome was assessed by telephone interview at 3 months (±14 days) using the modified Rankin Scale (mRS); poor outcome was defined as an mRS score ≥3. Multiple logistic regression analysis was adjusted for age, ASPECTS, baseline NIHSS score, NIHSS score at 24 h, and recanalization therapy.

CXCL4 levels did not differ significantly between patients with poor and good outcomes [118.8 ng/ml vs. 119.5 ng/ml, p = 0.60], nor between non-survivors and survivors [127.2 ng/ml vs. 117.6 ng/ml, p = 0.85]. CXCL4 was not independently associated with poor outcome [aOR: 0.33; 95% CI: 0.04-2.06].

CXCL4 is abundantly released following platelet activation and has therefore emerged as a promising biomarker candidate. However, systemic CXCL4 levels were not associated with functional outcome in AIS.

These findings suggest that early venous CXCL4 levels are not a suitable biomarker for predicting functional outcome after AIS.