Predictive value of nerve injury-induced protein-1 on first-pass effect in patients with acute ischemic stroke

Ge Qiuying; Ji Enfei; Liao Dan; Tang Boru; Hao Xinbin

doi:10.3969/j.issn.1671-6450.2025.07.008

Abstract：Objective To explore the predictive value of Nerve Injury-induced Protein-1(NINJ1)for the first-pass effect in patients with acute ischemic stroke(AIS).Methods A total of 104 AIS patients who underwent mechanical throm-bectomy in the Neurology Department of Liaoyang Central Hospital from January 2024 and December 2024 were enrolled in the AIS group,another 30 health check-up participants who underwent physical examination in our hospital during the same period were selected as the healthy control group.AIS patients were divided into pass subgroups(32 cases)and non-pass subgroups(72 cases)based on whether first-pass effect was achieved.Clinical and surgical data were collected,and serum NINJ1 levels were measured using ELISA.Pearson correlation analysis was performed to assess the association between serum NINJ1 levels and clinical parameters in AIS patients.Multivariate logistic regression analysis was used to identify factors influencing the first-pass effect in AIS patients.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of clinical indicators for the first-pass effect.Results Serum NINJ1 levels were significantly higher in the AIS group compared to the healthy control group(t/P=6.999/＜0.001).The pass subgroups exhibited lower age,National Institutes of Health Stroke Scale(NIHSS)scores,and serum NINJ1 levels,but higher clot burden scores(CBS)com-pared to the non-pass subgroups(t/P=2.865/0.005,2.703/0.008,5.608/＜0.001,6.194/＜0.001).Pearson correlation analysis showed that serum NINJ1 levels positively correlated with NIHSS scores(r/P=0.364/0.012)and negatively with CBS(r/P=-0.452/＜0.001).Multivariate Logistic regression analysis showed that low age,low NIHSS score and low serum NINJ1 level were protective factors for AIS patients' first-pass effect[OR(95％CI)=0.807(0.660-0.985),0.751(0.585-0.966),0.628(0.414-0.954)],while low CBS score was a risk factor[OR(95％CI)=2.179(1.155-4.113)].The CBS scores and ser-um NINJ1 level had high predictive value for first-pass effect,with areas under the curve(AUC)of 0.772 and 0.763,respec-tively.Combining CBS score and serum NINJ1 level further improved the AUC to 0.899(Z=2.170,2.412,P=0.030,0.016).Conclusion NINJ1 is abnormally high expression in the serum of AIS patients,and its expression level is closely re-lated to whether the patients can obtain the first-pass effect.Serum NINJ1 has high application value in predicting the first-pass effect.