Circulating STXBP5 as an Early Diagnostic Biomarker of Acute Ischemic Stroke and Its Association with Initial Neurological Severity
DOI:
https://doi.org/10.46649/zfqad328Keywords:
Acute ischemic stroke; STXBP5; Diagnostic biomarker; NIHSS; D-dimer.Abstract
Abstract
Background:
Acute ischemic stroke (AIS) is a significant global health crisis and a leading cause of long-term disability. While traditional risk factors are well documented, there is a critical need for novel biochemical markers that reflect early endothelial and hemostatic disruption. Syntaxin-binding protein 5 (STXBP5), also known as tomosyn, is a regulator of endothelial exocytosis and von Willebrand factor (VWF) secretion; however, its clinical application in AIS diagnosis remains under-investigated.
Objectives: This study aimed to evaluate the diagnostic utility of serum STXBP5 levels in patients within the first 24 hours of AIS onset and to examine their association with the initial neurological severity of AIS.
Materials and Methods: A case-control study was conducted in Najaf City, Iraq, involving 60 patients with neurologist-confirmed AIS and 60 age- and sex-matched healthy controls. Serum STXBP5 concentrations were measured using a quantitative enzyme-linked immunosorbent assay (ELISA). Clinical severity was recorded using the National Institutes of Health Stroke Scale (NIHSS).
Results: Serum STXBP5 levels were significantly elevated in the AIS group (3.15 ± 0.72 ng/mL) compared with healthy controls (2.22 ± 0.66 ng/mL, p = 0.001). STXBP5 showed weak but statistically significant positive correlations with higher NIHSS scores at admission (r = 0.316, p = 0.014) and D-dimer levels (r = 0.278, p = 0.032). Receiver operating characteristic (ROC) analysis yielded an area under the curve (AUC) of 0.88. At a cut-off value of 2.51 ng/mL, STXBP5 showed 90.7% sensitivity and 75.4% specificity.
Conclusion: Serum STXBP5 levels are markedly elevated during the first 24 hours of AIS and show weak but statistically significant positive associations with both initial neurological severity and D-dimer levels. These findings support the potential utility of STXBP5 as an accessible biomarker of early endothelial-hemostatic stress in AIS, while emphasizing the need for external validation before clinical implementation.
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