Prognostic value of serum sirt6 in predicting short-term functional outcome in patients treated with thrombolysis for acute ischemic stroke

Sirtuins 6 (Sirt6) is a defatting acylase that protects against atherosclerosis and ischemic stroke. It has a high clinical reference value in predicting clinical outcomes such as cerebral hemorrhage, cerebral ischemia, and myocardial infarction. This study aimed to investigate the connection between serum Sirt6 levels and short-term prognosis among patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis with tissue-type plasminogen activator (rt-PA). This study involved AIS patients undergoing intravenous thrombolysis by rt-PA, and found that the serum Sirt6 level were significantly lower in the poor prognosis group than in the good prognosis group (p < 0.05), while the poor prognosis group’s age, neutrophil count, atrial fibrillation, D-dimer level, and pre-thrombolysis National Institutes of Health Stroke Scale (NIHSS) score were significantly higher (p < 0.05). With a cut-off value of 689 ng/mL, receiver operating characteristic (ROC) analysis revealed that the area under the curve (AUC) of serum sirt6 for predicting a poor prognosis following intravenous thrombolytic therapy in AIS patients was 0.841, with corresponding sensitivity and specificity of 90.74% and 70.06%. Poor outcome was independently influenced by age, pre-thrombolysis NIHSS score, platelet counts, D-dimer, and Sirt6 level (p < 0.05). A nomogram prediction model was created based on multivariate logistic regression results, and its AUC was 0.972. The Hosmer-Lemeshow test (χ2 = 5.766, p = 0.673) and calibration curve analysis showed an acceptable fit for the prediction model. Decision analysis curves were also used to confirm the clinical utility of the model. In conclusion, Serum sirt6 was found to be a novel biomarker for predicting AIS patients treated with rt-PA, and sirt6-based nomograms may become a valuable tool for predicting AIS patients’ long-term prognosis.

Acute ischemic stroke; Clinical study; Intravenous thrombolysis; Prognosis; Sirtuins 6

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