Aims To explore the correlation between serum Cysteine cathepsin L (CTSL) and acute atherosclerotic cerebral infarction and provide potential value for clinical prediction of progress and prognosis of acute ischemic stroke (AIS).
Methods 121 AIS patients with large aortic atherosclerotic (LAA) type, 40 AIS patients with small artery occlusion (SAO) by TOAST classification and 40 healthy controls (HC) were enrolled. The levels of serum CTSL were assessed using an enzyme-linked immunosorbent assay.
Results The serum CTSL level in LAA group was both significantly higher than that in HC and SAO group (P<0.05). Among LAA patients, patients with stroke progression (NHISS increase≥2) had significantly higher serum CTSL than that without stroke progression (P<0.05). Multivariate regression analysis revealed that serum CTSL level (OR 1.024, 95% CI 1.012-1.036, P<0.05) was independent risk factors for the progression in the LAA patients. Meanwhile, serum CTSL level of patients with poor prognosis (MRS≥2) was significantly higher than those with good prognosis (P<0.05) when after three months evaluation. Furthermore, multivariate regression analysis showed that serum CTSL level (OR 1.031, 95% 1.014-1.047, P<0.05) was also independent risk factors for poor prognosis of LAA cerebral infarction. The area under curve (AUC) of serum CTSL for predicting stroke progression and poor prognosis in acute LAA cerebral infarction was 0.773 and 0.783, respectively, by ROC curve analysis.
Conclusions The findings suggested the increase of serum CTSL level may be an independent risk factor for the progression and poor prognosis of acute atherosclerotic cerebral infarction.