Serum sCD40L and galectin-3 in the prognosis prediction of patients with acute ischemic stroke.

BACKGROUND

To explore the value of serum soluble CD40ligand (sCD40L) and galectin-3 (galectin-3) for predictingthe therapeutic effect and prognosis of patients with acuteischemic stroke (AIS).

METHODS

180 AIS patients admitted to the hospitalbetween March 2023 and March 2025 were selected asresearch participants. All patients received emergencytreatment with tenecteplase (TNK-tPA) combined withXuesaitong. Based on the therapeutic effect, patients weredivided into two groups: an effective group and an ineffective group. Serum sCD40L and galectin-3 levels weremeasured in both groups before treatment and 4 weeksafter, and the levels were compared. After discharge, allpatients were monitored for 3 months, and, based on theirmodified Rankin Scale (mRS) score, those with a goodprognosis and those with a poor prognosis were assignedto two groups. Using multivariate logistic regression, therisk factors associated with poor prognosis and inadequatetreatment in AIS patients were examined. Serum levels ofsCD40L and galectin-3 were analysed using a receiveroperating characteristic (ROC) curve to assess their prognostic value for poor prognosis and ineffective treatment inAIS patients.

RESULTS

Of the 180 research subjects, 146 were effectivelytreated (effective group), while 34 were ineffective (ineffective group). There were 142 patients with a good prognosisand 38 with a poor prognosis, representing an incidence of21.11%. After 4 weeks of treatment, serum levels ofsCD40L and galectin-3 were lower in the successful group than in the unsuccessful group (P< 0.05). Serum levels ofsCD40L and galectin-3 were higher in the poor-prognosisgroup than in the favourable-prognosis group (P< 0.05).Multivariate logistic regression analysis showed that AISpatients with elevated serum galectin-3 and sCD40L levelswere at increased risk of inadequate treatment and pooroutcomes (P< 0.05). The areas under the curve (AUCs) forserum galectin-3 and sCD40L in predicting treatment failure in AIS patients were 0.665 and 0.691, respectively,according to ROC analysis; the specificities were 70.08%and 77.51% , respectively, and the sensitivities were 62.53%and 62.58%, respectively. The combined prediction modelfor ineffective treatment using serum galectin-3 andsCD40L yielded an AUC of 0.784, with specificities andsensitivities of 65.18% and 81.25%, respectively. For predicting poor prognosis, serum galectin-3 and scd40ldemonstrated AUCs of 0.774 and 0.838, respectively; theirspecificities were 67.58% and 75.36% , respectively, whiletheir sensitivities were 75.06% and 80.04% , respectively.The combined prediction of serum galectin-3 and scd40lfor poor prognosis was less effective, with an AUC of 0.919,a specificity of 60.05%, and a sensitivity of 90.63%.

CONCLUSIONS

Both sCD40L and serum galectin-3 levelshave some prognostic value for poor prognosis and ineffective treatment in AIS patients, and combining their detection can significantly improve predictive efficacy.