Prognostic performance of blood neurofilament light chain for functional outcomes in patients with ischemic stroke: a systematic review and meta-analysis.
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引用次数: 0
Abstract
Introduction: This meta-analysis aimed to assess the association between blood neurofilament light chain (NfL) and functional outcomes in patients with ischemic stroke.
Methods: PubMed, Web of Science, Embase, Cochrane Library, and the China National Knowledge Infrastructure database were searched from inception through March 15, 2026. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled to quantify the association between blood NfL and functional outcomes in patients with ischemic stroke. We pooled the area under the curve (AUC), sensitivity, and specificity; conducted meta-regression and sensitivity analyses; and assessed publication bias.
Results: A total of 18 studies involving 3,448 patients were included in this meta-analysis. The pooled results demonstrated that blood NfL was associated with poor functional outcomes after ischemic stroke (OR = 1.78, 95% CI: 1.41-2.24, p < 0.001, I2 = 87.5%, p < 0.01). The pooled AUC for blood NfL in predicting functional outcomes in patients with ischemic stroke was 0.79 (95% CI: 0.75-0.82), with 71% (95% CI: 62-79%) sensitivity and 74% (95% CI: 67-80%) specificity. Subgroup analyses and meta-regression revealed that participant age, sample size, study design, blood sample type, assay method, proportion of poor functional outcomes, blood sampling time, reperfusion therapy rate, National Institutes of Health Stroke Scale score, definition of poor functional outcome, and the proportion of large artery atherosclerosis were not identified as significant sources of heterogeneity. Sensitivity analysis indicated that the pooled estimate was robust. Begg's test also showed no evidence of publication bias (p = 0.753), although Egger's test suggested the presence of publication bias (p < 0.001). The trim-and-fill method showed that the overall effect of this meta-analysis was stable.
Conclusion: This meta-analysis showed that elevated blood NfL levels may have prognostic value for functional outcomes in patients with ischemic stroke. However, given the substantial between-study heterogeneity and the presence of publication bias, these findings should be interpreted with caution.
期刊介绍：
The section Stroke aims to quickly and accurately publish important experimental, translational and clinical studies, and reviews that contribute to the knowledge of stroke, its causes, manifestations, diagnosis, and management.
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