Plasma neuropeptide Y levels and adverse clinical outcomes after acute ischaemic stroke.

Background And Purpose: Neuropeptide Y (NPY) has been reported to be involved in the pathophysiology of several cardiovascular disease processes and might contribute to the incidence of stroke, but the prognostic utility of circulating NPY after acute ischaemic stroke is unclear. This study aimed to prospectively examine the association between plasma NPY levels and adverse clinical outcomes after acute ischaemic stroke.

Methods: Plasma NPY levels were measured in 3250 patients (2066 men and 1184 women) from the China Antihypertensive Trial in Acute Ischaemic Stroke. The primary outcome was the combination of death and major disability (modified Rankin Scale score ≥3) at 12 months after stroke onset, and secondary outcomes included major disability, death and cardiovascular events.

Results: During the 12-month follow-up, 702 participants (21.6%) experienced major disability or died. After multivariable adjustment, odds ratio (95% confidence interval) for the highest quartile of NPY was 1.56 (1.19-2.04) for the primary outcome, compared to the lowest quartile. Each standard deviation (0.27 ng/mL) higher log-transformed NPY was associated with an odds ratio (95% confidence interval) of 1.18 (1.07-1.30) for the primary outcome, 1.28 (1.15-1.42) for major disability. The addition of NPY to a conventional risk factors model improved risk prediction of the composite outcome of death and major disability (category-free net reclassification index 8.82%, p = 0.040; integrated discrimination improvement 0.38%, p = 0.011).

Conclusions: Elevated plasma NPY levels in the acute phase of ischaemic stroke were associated with increased risk of poor clinical outcomes after ischaemic stroke, suggesting that plasma NPY may be a potential prognostic biomarker for ischaemic stroke.