Exploring the Association Between Serum Neurogranin, Nardilysin, and Ischemic Stroke: A Case-Control Study Conducted in the Emergency Department

BACKGROUND Ischemic stroke (IS) is a major cause of mortality and disability worldwide. Rapid and accurate diagnosis in the emergency department (ED) is crucial for improving outcomes. Neurogranin (Ng), a postsynaptic protein involved in synaptic plasticity, and Nardilysin (NRDC), a metallopeptidase with neuronal functions, have been linked to various neurological disorders. This study examines their potential diagnostic and prognostic value in IS. MATERIAL AND METHODS This prospective case-control study was carried out in a high-volume ED between June and October 2023. A total of 44 IS patients and 44 healthy controls, matched for age and sex, were included. Serum levels of Ng and NRDC were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses involved receiver operating characteristic (ROC) analysis to assess diagnostic value and comparisons of biochemical parameters between groups. RESULTS Ng levels were significantly higher in IS patients compared to controls (281.12±32.12 pg/mL vs 265.71±24.54 pg/mL, P=0.01), with moderate diagnostic accuracy (area under curve=0.624). Elevated Ng levels were associated with intensive care unit admission (311.50±46.13 pg/mL, P=0.023). NRDC levels showed no significant differences between groups or clinical outcomes. Biochemical parameters, including elevated urea and creatinine and reduced hemoglobin levels, showed the systemic impacts of IS. CONCLUSIONS Ng may have a limited role as a biomarker in IS diagnosis, while its potential prognostic value requires further validation. NRDC did not show significant utility in this study. Larger studies incorporating additional biomarkers are needed to determine whether Ng can provide clinical insights into IS diagnosis and prognosis.