Serum Neurogranin as a Diagnostic Biomarker for Acute Ischemic Stroke: Performance Comparison Between Thrombotic and Embolic subtypes

<ns3:p>Background Ischemic stroke (IS) is a severe neurological disorder that can lead to disability and mortality in adults. The management of acute ischemic stroke (AIS) requires the ability to predict functional outcomes. Blood biomarkers are valuable prognostic tools because of their rapid assessment, cost-effectiveness, and clinical accessibility. Given that Neurogranin (Ng) is a small postsynaptic neural protein, and when the blood-brain barrier (BBB) is damaged, Ng levels are altered in the bloodstream. Methods This study aimed to assess the concentration of Ng in patients with acute ischemic stroke. We investigated forty-six thrombotic patients, forty-five embolic patients, and forty-five healthy individuals. Serum concentrations of Ng, D-dimer, random blood sugar (RBS), lipid profile, renal function tests, liver function tests, complete blood count (CBC), and electrolyte tests were performed for all participants. Results The results revealed that the embolic group had the highest serum level of Ng compared to the thrombotic and control groups (0.600±0.339 ng/ml, 0.464±0.121 ng/ml, and 0.304±0.065 ng/ml, respectively). Moreover, correlation analysis revealed that serum Ng was positively correlated with some biomarker parameters, specifically platelets, total cholesterol (TC), and low-density lipoprotein (LDL), in the embolic group. Meanwhile, Receiver Operating Characteristic (ROC) Curve analysis yielded area under the curve (AUC) values of 0.879 vs. 0.897 for the thrombotic and embolic groups, respectively. Conclusion These results led us to conclude that the assessment of serum Ng levels suggests that it can be used as a successful diagnostic parameter for ischemic stroke patients during the early stages of the disease.</ns3:p>