Angiopoietin‐like protein 4 and clinical outcomes in ischemic stroke patients

Abstract

Aims Angiopoietin‐like protein 4 (ANGPTL‐4) had been reported to be associated with the risk of ischemic stroke, but its prognostic value remained unclear. The aim of this study was to investigate the association between plasma ANGPTL‐4 concentrations and prognosis of ischemic stroke. Methods Baseline plasma ANGPTL‐4 concentrations were measured in 3379 acute ischemic stroke patients. The primary outcome was a combination of death or major disability (modified Rankin Scale score, ≥3) at 3 months after ischemic stroke. Results At 3 months after ischemic stroke, 850 (26.16%) participants experienced major disability or died (750 major disabilities and 100 deaths). After adjusting for important covariates, odds ratios for the highest tertile of plasma ANGPTL‐4 concentrations were 1.59 (1.22–2.06) for primary outcome, 1.53 (1.18–1.97) for major disability, and 2.03 (1.03–4.00) for death when compared with the lowest tertile of plasma ANGPTL‐4 concentrations. For 1‐SD increase in log‐ANGPTL‐4 concentrations (0.44 ng/mL), the adjusted odds ratios were 1.24 (1.11–1.38), 1.14 (1.03–1.27), and 1.72 (1.32–2.23), respectively. Adding ANGPTL‐4 to a model containing conventional risk factors improved risk prediction for composite outcome of death and major disability. Conclusion Higher plasma ANGPTL‐4 concentration was associated with poor prognosis in acute ischemic stroke patients, suggesting that ANGPTL‐4 might be a prognostic marker for ischemic stroke.

Comparative transcriptome findings reveal the neuroinflammatory network and potential biomarkers to early detection of ischemic stroke

“…In addition, we also observed the overexpression of an angiopoietin gene family, including angiopoietin-like protein 4 (Angptl4) and Angpt2. Angptl4 is already reported as a prognostic marker for ischemic stroke because higher levels of Angptl4 in the plasma were associated with poor prognosis in acute ischemic stroke patients and were a predictive biomarker in atherosclerosis [ 21 , 22 ]. Many clinical studies have suggested using Angptl4 for post-stroke treatment because it could enhance angiogenesis and neurogenesis by reducing neuronal death and inflammatory response [ 23 ].…”

Emerging roles of angiopoietin‐like proteins in inflammation: Mechanisms and potential as pharmacological targets

“…ANGPTLs are involved in multiple inflammatory diseases including metabolic syndrome (Tabata et al, 2009), acute organ injuries (Amadatsu et al, 2016; Guo et al, 2015; Yang et al, 2018; Zheng et al, 2021), chronic organ/tissue injuries or repair (Cho et al, 2019; Nishiyama et al, 2021; Okada et al, 2010), cancer progression (Aoi et al, 2011; Gao et al, 2015; Sasaki et al, 2012) and other inflammation‐related diseases (Tanigawa et al, 2016). Several studies have indicated that the effects of ANGPTLs in these diseases are mediated by both their classical roles in modulating lipid metabolism or angiogenesis and via regulating inflammation (Aryal et al, 2016; Li et al, 2019; Morinaga et al, 2016; Thorin‐Trescases & Thorin, 2017).…”

Correlation between serum ANGPTL4 levels and white matter hyperintensity and cognitive impairment in patients with cerebral small vessel disease

“…ANGPTL4 participates in the process of atherosclerosis by mediating the activity of lipoprotein lipase to regulate glucose and lipid metabolism (Aryal et al, 2019;Fernández-Hernando & Suárez, 2020). In addition, ANGPTL4 is involved in the regulation of angiogenesis, vascular permeability, chronic inflammation, and hematopoietic stem cell proliferation (Fernández-Hernando & Suárez, 2020;Zheng et al, 2021).…”

“…Previous studies have demonstrated that ANGPTL4 can be expressed in coronary heart disease (CHD) (Katanasaka et al., 2022 ), hypertension (Abu‐Farha et al., 2018 ), and ischemic stroke (Zheng et al., 2021 ). Studies also showed that ANGPTL4 may play a role in the pathogenesis of neurodegenerative disease.…”