TY - JOUR
T1 - Vasoregulatory Autoantibodies and Clinical Outcome After Ischemic Stroke— PROSCIS-B
AU - Liman, Thomas G.
AU - Siegerink, Bob
AU - Piper, Sophie
AU - Catar, Rusan
AU - Moll, Guido
AU - Riemekasten, Gabriela
AU - Heidecke, Harald
AU - Heuschmann, Peter U.
AU - Elkind, Mitchell S.V.
AU - Dragun, Duska
AU - Endres, Matthias
N1 - Publisher Copyright:
© 2023 The Authors.
PY - 2023/12/5
Y1 - 2023/12/5
N2 - BACKGROUND: Vasoregulatory autoantibodies including autoantibodies targeting G-protein–coupled receptors might play a functional role in vascular diseases. We investigated the impact of vasoregulatory autoantibodies on clinical outcome after ischemic stroke. METHODS AND RESULTS: Data were used from the PROSCIS-B (Prospective Cohort With Incident Stroke–Berlin). Autoantibody-targeting receptors such as angiotensin II type 1 receptor (AT1R), endothelin-1 type A receptor, complement factor-3 and-5 receptors, vascular endothelial growth factor receptor-1 and-2, vascular endothelial growth factor A and factor B were measured. We explored associations of high antibody levels with (1) poor functional outcome defined as modified Rankin Scale >2 or Barthel Index <60 at 1 year after stroke, (2) Barthel Index scores over time using general estimating equations, and (3) secondary vascular events (recurrent stroke, myocardial infarction) or death up to 3 years using Cox proportional hazard models. We included 491 patients with ischemic stroke with data on autoantibody levels and outcome. In models adjusted for demographics and vascular risk factors, high autoantibody concentrations (quartile 4) targeting complement factor C3a receptor, vascular endothelial growth factor receptor-2, and vascular endothelial growth factor B were associated with poor functional outcome at 1 year: (odds ratio, 2.0 [95% CI, 1.1–3.6]; odds ratio, 1.8 [95% CI, 1.1–3.2]; and odds ratio, 2.1 [95% CI, 1.2–3.6], respectively) and with lower Barthel Index scores over 3 years (complement factor C3a receptor: adjusted β=−3.3 [95% CI, −5.7 to −0.5]; VEGF-B: adjusted β=−2.4 [95% CI, −4.8 to −0.06]). Patients with high autoantibody levels were not at higher risk for secondary vascular events or death. CONCLUSIONS: High levels of autoantibodies against vascular endothelial growth factor receptor-2, vascular endothelial growth factor B, and complement factor C3a receptor measured are associated with poor functional outcome after stroke but not with recurrent vascular events or death. REGISTRATION: URL: https://www.clinicaltrials.govUnique identifier: NCT01363856.
AB - BACKGROUND: Vasoregulatory autoantibodies including autoantibodies targeting G-protein–coupled receptors might play a functional role in vascular diseases. We investigated the impact of vasoregulatory autoantibodies on clinical outcome after ischemic stroke. METHODS AND RESULTS: Data were used from the PROSCIS-B (Prospective Cohort With Incident Stroke–Berlin). Autoantibody-targeting receptors such as angiotensin II type 1 receptor (AT1R), endothelin-1 type A receptor, complement factor-3 and-5 receptors, vascular endothelial growth factor receptor-1 and-2, vascular endothelial growth factor A and factor B were measured. We explored associations of high antibody levels with (1) poor functional outcome defined as modified Rankin Scale >2 or Barthel Index <60 at 1 year after stroke, (2) Barthel Index scores over time using general estimating equations, and (3) secondary vascular events (recurrent stroke, myocardial infarction) or death up to 3 years using Cox proportional hazard models. We included 491 patients with ischemic stroke with data on autoantibody levels and outcome. In models adjusted for demographics and vascular risk factors, high autoantibody concentrations (quartile 4) targeting complement factor C3a receptor, vascular endothelial growth factor receptor-2, and vascular endothelial growth factor B were associated with poor functional outcome at 1 year: (odds ratio, 2.0 [95% CI, 1.1–3.6]; odds ratio, 1.8 [95% CI, 1.1–3.2]; and odds ratio, 2.1 [95% CI, 1.2–3.6], respectively) and with lower Barthel Index scores over 3 years (complement factor C3a receptor: adjusted β=−3.3 [95% CI, −5.7 to −0.5]; VEGF-B: adjusted β=−2.4 [95% CI, −4.8 to −0.06]). Patients with high autoantibody levels were not at higher risk for secondary vascular events or death. CONCLUSIONS: High levels of autoantibodies against vascular endothelial growth factor receptor-2, vascular endothelial growth factor B, and complement factor C3a receptor measured are associated with poor functional outcome after stroke but not with recurrent vascular events or death. REGISTRATION: URL: https://www.clinicaltrials.govUnique identifier: NCT01363856.
UR - http://www.scopus.com/inward/record.url?scp=85178998629&partnerID=8YFLogxK
U2 - 10.1161/JAHA.123.032441
DO - 10.1161/JAHA.123.032441
M3 - Journal articles
C2 - 38014691
AN - SCOPUS:85178998629
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 23
M1 - e032441
ER -