Determination of Netrin-1 Levels in Patients that Applied to Emergency Department with Stroke and its Effects on Survival for 6 Months

Introduction: We aimed to observe whether there are differences in patients presenting to the emergency department that has stroke, determination of serum levels of netrin-1, and its impact on patient survival and determine the effect on survival and stroke patients according to the type of netrin-1 levels. Methods: The study was held in the Konya Education and Research Hospital, Emergency Department between 1st of August, 2012 and 30th of November, 2012. Patients divided into sub groups after determination of hemorrhagic and ischemic stroke. Control group was created with the patients that did not have stroke. In both groups, Netrin-1 levels were studied. Findings: Totally 131 stroke 51 control patiens were enrolled the study. %13 of the patients were with hemorrhagic where as the other %87 was ischemic stroke. In the stroke group Netrin-1 was lower than the control group (p=0,003 and p<0,001). In order to distinguish between control and case groups, related with Netrin-1 ROC curve was statistically significant 0,739 (%95 Confidence Interval: 0,664-0,814). Best cutoff point for Netrin-1 is determined as 728.4. The sensitivity of Netrin-1 at this point is %71,0; selectivity is %68,6; positive predictive value is %85,3; negative predictive value is %47,9; and finally accuracy rate was found as %70,3. Although in the hemorrhagic stroke Netrin-1 is lower than ischemic stroke, the difference between groups was not statistically significant (p=0,297). There was not statistically significant difference in terms with among the patients the median survival and die patients related with Netrin-1. Discussion: Netrin-1 precursor protein is important for neural and vascular development. Netrin-1 regulates cell migration and axon in the brain in utero. On the other hand, in the SSS damage, injured in sections the migration of adult neural stem cells is located. In determining the prognosis of stroke and mortality in the literature, many markers are used. Result: Our study is the first study on this subject in stroke patients have low levels of netrin-1. According to the type of stroke did not detect a difference in netrin-1 levels. Netrin-1 levels were not associated with mortality.