Serum Human epididymal protein 4 as a predictor of adverse events in acute ischemic stroke patients receiving antiplatelet therapy

BACKGROUND: Acute kidney injury (AKI) frequently develops in certain patients with acute ischemic stroke (AIS) and often indicates a poor prognosis. However, the relationship between serum human epididymal protein 4 (HE4), a newly recognized biomarker of renal injury, and adverse outcomes in AIS patients remains unclear. AIM: This study aimed to investigate the prognostic value of admission serum HE4 levels for predicting unfavorable outcomes in AIS patients undergoing antiplatelet therapy. METHODS: We conducted a cohort study involving 144 consecutive adult patients admitted for AIS who received antiplatelet treatment. Blood samples were collected after admission to measure serum HE4 concentrations. RESULTS: Serum HE4 levels were markedly elevated in AIS patients on antiplatelet therapy compared with healthy controls (116.4 ± 24.8 pmol/L vs. 25.3 ± 9.8 pmol/L). Kaplan-Meier analysis revealed that higher HE4 levels were associated with an increased incidence of cardiovascular events and/or recurrent stroke. Multivariate Cox regression analysis indicated that elevated HE4 concentrations independently predicted a higher risk of cardiovascular events (HR = 3.02; 95% CI: 1.51-6.29; P = 0.01) and stroke recurrence (HR = 3.81; 95% CI: 1.64-6.63; P < 0.01). CONCLUSIONS: Elevated serum HE4 levels are significantly associated with a heightened risk of cardiovascular events and recurrent stroke in AIS patients receiving antiplatelet therapy, suggesting that HE4 may serve as a potential biomarker for predicting adverse outcomes in this population.