Investigation of the potential use of profilin-l (PFN-I) and homocysteine levels as biomarkers in ischemic stroke patients in disadvantaged situations

Aim:. The aim of this study is to determine whether additional laboratory parameters such as serum PFN-1 and Homocysteine, in addition to imaging methods, can be used as predictors for early diagnosis, disease course, and treatment planning in patients with disadvantaged conditions who are suspected of having ischemic stroke in the emergency department. Materials and Methods: Our study was planned as a prospective, observational, and descriptive study. 117 patients presenting to the Harran University Faculty of Medicine Emergency Department with stroke symptoms were included in the study. 117 healthy controls of similar age and sex with no history of ischemic stroke were selected as the control group. Demographic characteristics of the patients and healthy controls included in the study, complaints regarding emergency department presentation, time from symptom onset to emergency department presentation, vital signs at presentation, detailed medical history, physical examination and detailed neurological examination findings, NIHHS score, GCS, ECG, and ASPECTS were recorded using a study form. During their follow-up in the emergency department, brain CT, diffusion MRI, and brain CT angiography were performed, and blood samples were collected for serum PFN-1 and homocysteine levels. IBM SPSS 25.0 was used for all analyses. Results: In our study, serum homocysteine and PFN-1 levels were found to be statistically significantly higher in the patient and control groups compared to the healthy control group. When the patient groups were grouped according to the time from symptom onset to emergency room presentation (0–4.5 hours, 4.5–6 hours, and >6 hours), no statistically significant differences were found between the groups in terms of relevant parameters. However, serum homocysteine levels were found to be statistically significantly higher in the patient groups admitted for 0–6 hours compared to the patient group admitted for >6 hours. No statistically significant differences were found between the vascular etiological subgroups (main and small vessels) and parameters related to treatment methods. Conclusion: In this study, serum PFN-1 and Homocysteine levels were examined in ischemic stroke patients admitted to the emergency department and in healthy controls. Findings showed that both biomarkers were statistically significantly higher than in healthy controls. This result suggests that serum PFN-1 and homocysteine can be used as baseline assessments and as diagnostic biomarkers following neurological examination in vulnerable patients with suspected ischemic stroke presenting to the emergency department. However, no statistically significant association was found between these parameters and stroke severity, distinguishing between vascular etiological subgroups (main and small vessel involvement), determining treatment preferences, or predicting discharge status. Their clinical applications should be clarified with larger prospective studies.