Journal of Clinical Medicine最新文献

{"title":"RETRACTED: Ahmad et al. Phytomedicine-Based Potent Antioxidant, Fisetin Protects CNS-Insult LPS-Induced Oxidative Stress-Mediated Neurodegeneration and Memory Impairment. <i>J. Clin. Med.</i> 2019, <i>8</i>, 850.","authors":"Ashfaq Ahmad, Tahir Ali, Shafiq Ur Rehman, Myeong Ok Kim","doi":"10.3390/jcm15176785","DOIUrl":"10.3390/jcm15176785","url":null,"abstract":"<p><p>The Journal retracts the article \"Phytomedicine-Based Potent Antioxidant, Fisetin Protects CNS-Insult LPS-Induced Oxidative Stress-Mediated Neurodegeneration and Memory Impairment\" [...].</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 17","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Padrós-Augé et al. Effects of Strength Training on Neck Muscle Function and Tenderness in Patients with Chronic Headache: A Secondary Analysis of a Clinical Trial. <i>J. Clin. Med.</i> 2025, <i>14</i>, 7364.","authors":"Jordi Padrós-Augé, Gemma Victoria Espí-López, Henrik Winther Schytz, Karen Søgaard, Rafel Donat-Roca, Henrik Baare Olsen, Bjarne Kjeldgaard Madsen","doi":"10.3390/jcm15166465","DOIUrl":"10.3390/jcm15166465","url":null,"abstract":"<p><p>In the original publication [...].</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Assisted Analysis of Retinal Pigment Epithelium Tears in Patients with Neovascular Age-Related Macular Degeneration Treated with Aflibercept (2 mg and 8 mg) and Faricimab: A Single-Centre Retrospective Case Series.","authors":"Veronika Eggarter, Ludovico Ruscitti, Niccolò Ascioti, Matteo Bonanata, Arianna Peyla, Filippo Simona, Moreno Menghini, Gabriela Grimaldi","doi":"10.3390/jcm15166478","DOIUrl":"10.3390/jcm15166478","url":null,"abstract":"<p><p><b>Purpose</b>: We aimed to describe retinal pigment epithelium (RPE) tears in patients with neovascular age-related macular degeneration (AMD) and pigment epithelial detachment (PED), focusing on OCT features and AI-assisted image analysis. <b>Methods</b>: This retrospective case series included patients with neovascular AMD and PED who developed RPE tears between 2020 and 2025 after treatment with intravitreal aflibercept (2 mg or 8 mg) or faricimab. Multimodal imaging, including spectral-domain OCT and infrared imaging, was reviewed. PED morphology, fluid characteristics, RPE denudation, timing of RPE tear, and visual outcomes were analyzed using manual grading and AI-assisted software. <b>Results</b>: Among 375 PED-bearing eyes, 11 eyes of 11 patients developed an RPE tear (2.9%), of which 10 (90.9%) were temporally associated with anti-VEGF treatment. Rates were similar across agents-2.7% (aflibercept 2 mg), 3.0% (aflibercept 8 mg) and 2.4% (faricimab)-with no significant difference. Eight eyes (72.7%) were treatment-naïve and one tear (9.1%) occurred spontaneously after hemorrhage without recent injection. Among treatment-associated tears, 30% followed the first and 50% the second injection (mean 2.1 injections), detected a mean of 44 ± 30 days after the last injection. Mean baseline PED height was 594.8 ± 239.2 μm and median AI-derived PED volume was 2922 nL. Mean RPE-denudation area at detection was 5.25 ± 3.87 mm², remaining stable in 7 of 9 evaluable eyes. Visual acuity was stable or improved in seven eyes; four lost ≥15 ETDRS letters. <b>Conclusions</b>: RPE tears were an uncommon, predominantly early complication occurring in eyes with large PEDs, with no excess risk from second-generation agents. AI-assisted OCT may aid anatomical characterisation, and most eyes retained vision with continued therapy.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Fibrillation and Documented Heart Failure in Patients Hospitalized with COVID-19: A Secondary Analysis of a Single-Centre Cohort from Western Romania.","authors":"Ana-Maria Pah, Cristiana Adina Avram, Maria Rada, Gheorghe Stoichescu-Hogea, Adina Bucur, Dan Alexandru Surducan, Abdeldayem Mahmoud, Ovidiu Calin Ilie, Claudiu Avram, Emilia Elena Clej, Petra Alexandra Lazureanu, Maria-Laura Craciun","doi":"10.3390/jcm15166470","DOIUrl":"10.3390/jcm15166470","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Atrial fibrillation (AF) and heart failure (HF) frequently coexist, but later-pandemic data from Eastern Europe are limited. We evaluated their documented coexistence in patients hospitalized with COVID-19; the study was not designed to determine whether SARS-CoV-2 modifies the established AF-HF relationship. <b>Methods</b>: We retrospectively analysed 395 adults admitted with RT-PCR-confirmed SARS-CoV-2 infection between 1 September 2022 and 31 December 2024. AF was identified from the admission record, while HF was determined by an audited, rule-based review of cardiovascular free-text entries. A modified Poisson model with robust variance was the primary analysis and estimated adjusted prevalence ratios (aPRs) after adjustment for age, sex, body mass index, hypertension, ischaemic heart disease, pre-existing type 2 diabetes, chronic kidney disease, chronic obstructive pulmonary disease, smoking, and prior ischaemic stroke. Logistic regression and a restrictive NYHA-coded HF definition were sensitivity analyses. <b>Results</b>: AF was documented in 68 patients (17.2%), HF in 106 (26.8%), and both conditions in 26 (6.6%). HF prevalence was 38.2% among patients with AF and 24.5% among those without AF. AF was associated with documented HF in the primary model (aPR 1.51, 95% confidence interval 1.06-2.16; <i>p</i> = 0.022); age was also associated with HF (aPR 1.02 per year, 95% confidence interval 1.01-1.04; <i>p</i> = 0.010). Results were similar with the restrictive HF definition (aPR 1.54, 95% confidence interval 1.07-2.23) and logistic regression (adjusted odds ratio 1.89, 95% confidence interval 1.06-3.37). Exploratory mortality estimates were imprecise and were not used for prognostic inference. <b>Conclusions</b>: AF identified a subgroup with a higher prevalence of documented HF within this hospitalized COVID-19 cohort. The findings are best interpreted as evidence of cardiovascular and multimorbidity complexity, not as proof of a COVID-specific, temporal, or causal AF-HF effect.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Preoperative Cerebrovascular High-Risk Status and Long-Term Ischemic Stroke After EVAR.","authors":"Linyao Zhu, Chengxin Weng, Jichun Zhao, Bin Huang, Ding Yuan, Tiehao Wang, Jinting Ge, Huawei Zhang, Jiarong Wang","doi":"10.3390/jcm15166484","DOIUrl":"10.3390/jcm15166484","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the impact of asymptomatic high-risk status for ischemic stroke on patients with abdominal aortic aneurysm undergoing endovascular aortic repair (EVAR). <b>Methods:</b> Eligible patients with abdominal aortic aneurysm who underwent EVAR between January 2011 and December 2021 were enrolled in this retrospective cohort study. Propensity score matching (PSM) was used to balance baseline characteristics between the cerebrovascular high-risk group and the standard control group. The impact of cerebrovascular high-risk status on short- and long-term outcomes was assessed using Cox proportional hazards regression and generalized linear models, with results presented as hazard ratios (HRs), odds ratios (ORs), and corresponding 95% confidence intervals (CIs). <b>Results:</b> A total of 1080 patients were included (299 high-risk, 781 standard). During the 13-year follow-up period, ischemic stroke occurred in 45 patients (15.1%) in the high-risk group (HR, 7.01; 95% CI, 4.11-11.94; <i>p</i> < 0.001). The high-risk group also had a higher incidence of major adverse cardiovascular and cerebrovascular events (MACCEs), which occurred in 129 patients (43.1%) (HR, 1.78; 95% CI, 1.43-2.24; <i>p</i> < 0.001). These findings remained consistent across inverse probability of treatment weighting (IPTW) and propensity score matching combined with multivariable generalized linear model (PSM+MVA-GLM) analyses. <b>Conclusions:</b> Although no significant increase in perioperative cerebrovascular adverse events was observed in asymptomatic patients with a preoperative cerebrovascular high-risk status, their worse long-term prognosis appears to be associated with this risk status. This association highlights the need for rigorous cardiovascular and cerebrovascular risk management in this vulnerable population after surgery.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Management of Ovarian Hyperstimulation Syndrome with Furosemide at a Tertiary Referral Center-A Retrospective Data Analysis.","authors":"Daniel Mayrhofer, Katharina Walch, Marlene Hager, Rebecca Künz, Alina Hoeltz, Rodrig Marculescu, Johannes Ott, Julian Marschalek","doi":"10.3390/jcm15166468","DOIUrl":"10.3390/jcm15166468","url":null,"abstract":"<p><p><b>Background/Objective:</b> Ovarian hyperstimulation syndrome (OHSS) is a severe complication during controlled ovarian hyperstimulation. Ascites and consecutive hemoconcentration may lead to potentially life-threatening complications like thromboembolic events and the need for intensive care. The use of diuretics is widely used to treat ascites in non-OHSS patients. The aim of this study was to assess whether the use of furosemide in the treatment of OHSS was associated with a higher rate of complications compared to the literature. <b>Methods:</b> In this retrospective cohort study, 502 cases treated from January 2005 to June 2023 for OHSS at the Medical University of Vienna were evaluated regarding the distribution of OHSS severity, average duration of treatment, types and frequency of complications associated with antidiuretic treatment, and predictive factors for paracentesis. <b>Results:</b> The median AMH levels were 5.7 ng/mL. An antagonist protocol was used in 80% of stimulations. Human Chorionic Gonadotropin trigger was used in 80% of stimulations, with 71.7% of cases being early-onset. The incidence dropped from 8.4% (2006 to 2016) to 3.3% (from 2015 to 2023). The median duration of inpatient treatment was seven days, with about 75% of patients receiving furosemide as a diuretic treatment. Ascites drainage was necessary in 27.9%. None of our patients developed a thromboembolic complication following the furosemide treatment. <b>Conclusions:</b> During the study period, the incidence of OHSS declined, most probably as a result of advances in ovarian stimulation protocols and freezing strategies. In moderate to severe OHSS, standardized diuretic treatment with furosemide was not associated with additional thromboembolic complications as long as patients remain normovolemic.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Non-Surgical Management for Chronic Low Back Pain: A 5-Year Cohort Study from a Tertiary Spine Center in Northwest China.","authors":"Bolong Zheng, Hua Hui, Liang Yan, Baorong He","doi":"10.3390/jcm15166497","DOIUrl":"10.3390/jcm15166497","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Chronic low back pain (CLBP) is the leading global cause of years lived with disability, but long-term real-world evidence for non-surgical management remains scarce, particularly in low- and middle-income countries. This study aimed to describe 5-year trajectories of pain, disability, healthcare utilization, patient satisfaction, and surgical conversion among patients with non-specific CLBP initially managed non-surgically at a tertiary spine center in Northwest China. We also compared long-term outcomes between unimodal therapy and multidisciplinary biopsychosocial care and examined baseline demographic, clinical, and psychosocial predictors of treatment success and conversion to surgery. <b>Methods:</b> We conducted a 5-year retrospective cohort study of consecutive patients with non-specific CLBP at a tertiary spine center in Northwest China. Of 485 consecutive patients screened for eligibility, 420 were enrolled and were compared on the basis of unimodal therapy with multidisciplinary biopsychosocial care. Primary outcomes were pain (Numerical Pain Rating Scale, NPRS) and disability (Oswestry Disability Index, ODI), analyzed using linear mixed-effects models; predictors of surgical conversion were identified via multivariable Cox regression. <b>Results:</b> Of the 420 patients, 352 (83.8% retention) completed the 5-year follow-up. Both pain and disability improved substantially during the first 12 months. Thereafter, pain intensity increased slightly (NPRS from 4.8 to 5.4), whereas functional disability continued to improve (ODI from 31.7 to 26.5). Early multidisciplinary care was associated with sustained superior outcomes (adjusted functional disability (ODI) difference: -8.2 points at 5 years) and a 42% lower observed risk of surgery (HR = 0.58). The cumulative 5-year surgical rate was 14.2%, with high pain catastrophizing as the strongest independent predictor (HR = 3.10). <b>Conclusions:</b> In patients with non-specific CLBP, non-surgical management yields substantial 12-month gains; function continues to improve through 5 years, while pain shows partial recurrence. Early multidisciplinary biopsychosocial care was associated with more durable outcomes and lower surgical conversion; because treatment was not randomized, these associations warrant confirmation in pragmatic trials and support routine psychosocial screening and stratified care.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutropenia and Lymphopenia in Systemic Lupus Erythematosus: Distinct Phenotypes and Associated Factors in a Saudi Multicenter Study.","authors":"Roaa Aljohani, Ghada Aljanobi, Khawla K Alghanim, Nadeem Butt, Alaa Ahmed, Farah Alabbasi, Samar Alharbi","doi":"10.3390/jcm15166481","DOIUrl":"10.3390/jcm15166481","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Neutropenia and lymphopenia are common hematologic manifestations of systemic lupus erythematosus (SLE), but whether they represent distinct phenotypes is not well established. This study evaluated their prevalence, patterns, and associated factors. <b>Methods</b>: This multicenter retrospective study included 353 adults with SLE from three Saudi centers. Cytopenias were defined using prespecified laboratory criteria. Patients were classified as having neither abnormality, isolated neutropenia, isolated lymphopenia, or both. Multivariable logistic regression was used to assess factors associated with ever-neutropenia and ever-lymphopenia. <b>Results</b>: Leukopenia occurred in 141 patients (39.9%). Ever-neutropenia and ever-lymphopenia were each observed in 88 patients (24.9%); 47 (13.3%) had isolated neutropenia, 47 (13.3%) had isolated lymphopenia, and 41 (11.6%) had both abnormalities. Persistent neutropenia and lymphopenia occurred in 22 (6.2%) and 23 (6.5%) patients, respectively. Most neutropenia was mild, and only three patients had severe neutropenia. The four phenotypes differed in age, body mass index, autoimmune hemolytic anemia, platelet count, anti-Smith positivity, and immunosuppressive exposure. No included variable was independently associated with ever-neutropenia. Ever-lymphopenia was independently associated with male sex (aOR 2.66, 95% CI 1.22-5.81), anti-Smith positivity (aOR 2.71, 95% CI 1.40-5.24), and exposure to azathioprine (aOR 2.07, 95% CI 1.16-3.71), mycophenolate mofetil use (aOR 2.79, 95% CI 1.42-5.52), and rituximab use (aOR 3.83, 95% CI 1.50-9.75). <b>Conclusions</b>: Neutropenia and lymphopenia each occurred in one-quarter of patients with SLE, whereas persistent cytopenias were uncommon. No independent associations were identified for ever-neutropenia. The demographic, serologic, and treatment-related associations of ever-lymphopenia support separate evaluation of the two abnormalities in SLE.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Otitis Externa in a Newborn After Waterbirth-A Case Report Followed by a Literature Review.","authors":"Julia Ufnal, Maria Wolniewicz, Lidia Zawadzka-Głos","doi":"10.3390/jcm15166490","DOIUrl":"10.3390/jcm15166490","url":null,"abstract":"<p><p>Waterbirth has become a widely adopted alternative to a conventional delivery, with well-documented maternal benefits, but there is an ongoing debate regarding neonatal safety. We would like to report a case of a 10-day-old male neonate who developed acute otitis externa (AOE) following waterbirth. Despite the rare occurrence of this disease in children under 2 years of age, prompt diagnosis and timely initiation of appropriate therapy led to a full recovery. This case represents a previously undocumented, yet plausible, complication of waterbirth and underscores the importance of careful neonatal ear assessment and preventive measures in aquatic deliveries.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of High Serum Apelin Levels Within the First 24 h in Predicting 28-Day and Long-Term Mortality in Ischemic Cerebrovascular Disease.","authors":"Kübra Işık, Asım Tekin, Yakup Özer, Burak Mete","doi":"10.3390/jcm15166469","DOIUrl":"10.3390/jcm15166469","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The apelin/APJ system has demonstrated neuroprotective effects in experimental studies by regulating key pathogenic mechanisms of ischemic stroke, including oxidative stress, apoptosis, cerebral edema, and inflammation. This study aimed to investigate the role of serum apelin levels measured within the first 24 h in predicting 28-day and long-term mortality in patients with ischemic cerebrovascular disease. <b>Methods:</b> This prospective cohort study included 44 patients hospitalized with a diagnosis of acute ischemic stroke due to large artery atherosclerosis. Serum apelin levels were measured using the ELISA method from blood samples obtained within the first 24 h after symptom onset. Patients were prospectively followed for 28-day and long-term mortality. <b>Results:</b> During the follow-up period, 32.6% of the patients died. The median serum apelin level was significantly higher in the deceased group compared to the survivors [105.0 pg/mL vs. 55.8 pg/mL]. In ROC analysis, the area under the curve (AUC) for apelin in predicting mortality was 0.727 (95% CI: 0.550-0.903). The optimal cut-off value was determined as ≥70.47 pg/mL (sensitivity: 85.71%, specificity: 62.07%). In Kaplan-Meier analysis, the 28-day mortality rate was 52.2% in the high-apelin group (≥70.47 pg/mL), whereas it was 10.0% in the low-apelin group (<70.47 pg/mL) (<i>p</i> = 0.004). In multivariate Cox regression analysis, an apelin level <70.47 pg/mL was identified as an independent prognostic factor (HR: 0.16; 95% CI: 0.03-0.94). The cumulative survival rates at days 28, 56, and 180 were 56.1%, 46.7%, and 11.7%, respectively, in the high-apelin group, while these rates were 100%, 100%, and 81.8%, respectively, in the low-apelin group. The mean NIHSS score was significantly higher in the high-apelin group, and a strong, positive, and highly significant correlation was found between serum apelin level and NIHSS score (r = 0.703, <i>p</i> < 0.001). <b>Conclusions:</b> High serum apelin levels measured within the first 24 h in acute ischemic stroke are associated with increased 28-day and long-term mortality. The association of high endogenous apelin levels with poor prognosis in the clinical setting suggests that apelin is mobilized as a stress response during ischemia, and that elevated circulating levels may actually reflect the severity of the ischemic insult.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 16","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13514617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}