Can serum profilin-1 levels measured in acute ischemic stroke patients admitted to the emergency department be an indicator for the need for mechanical thrombectomy?

Objective: The aim of this study was to determine the value of serum profilin-1 levels measured in acute ischemic stroke patients in predicting large vessel occlusions requiring mechanical thrombectomy. Methods: This single-center, prospective, observational study was conducted on patients (patient group) and healthy volunteers (control group) who presented to the Emergency Department of Samsun University Samsun Education and Research Hospital with stroke symptoms between March 2023 and June 2023. Vital signs at admission, admission symptoms, symptom duration, comorbid diseases, Glasgow Coma Scale (GCS), National Institutes of Health Stroke Scale Score (NIHSS), Alberta Stroke Program Early Computed Tomography Score (ASPECTS), modified Rankin Score (mRS) at 3 months and treatment outcome were recorded. Serum profilin-1 levels were compared between the patient group and the control group. The patient group was categorized into those with and without large vessel occlusion and those with and without mechanical thrombectomy. Serum profilin-1 levels were compared between these groups. Results: In our study, 152 stroke patients constituted the patient group and 66 healthy volunteers constituted the control group. The patient and control groups were similar in terms of age and gender characteristics. The median serum profilin-1 level of the patient group was 4010.15 (286.4-5001) pg/mL, while the median serum profilin-1 level of the control group was 1919 (276-5001) pg/mL (p<0.001). We found that serum profilin-1 levels of ≥3669.02 pg/mL could diagnose stroke with %54.61 sensitivity and %89.39 specificity (AUC=0.733, 95% CI=0.669-0.791, p<0.001). Large vessel occlusion was present in %53.9 (n=82) of the patient group and the proportion of patients who underwent mechanical thrombectomy was %50 (n=76). The median serum profilin-1 level in patients who underwent mechanical thrombectomy was 4508.35 (557.1-5001) pg/mL, while the median serum profilin-1 level in patients who did not undergo mechanical thrombectomy was 2827.05 (286.4-5001) pg/mL (p=0.003). We found that serum profilin-1 levels ≥2143.1 pg/mL could predict patients undergoing mechanical thrombectomy with a sensitivity of %86.84 and specificity of %44.74 (AUC=0.638, 95% CI=0.556-0.714, p=0.002). Conclusion: Serum profilin-1 levels are a useful parameter in the diagnosis of ischemic stroke and in the prediction of large vessel occlusion requiring mechanical thrombectomy. Keywords: Acute Ischemic Stroke, Profilin-1, Large Vessel Occlusion, Mechanical Thrombectomy