Relationship between enuresis and obstructive sleep apnea–hypopnea syndrome in children

ObjectiveWe explored the relationship between enuresis and obstructive sleep apnea–hypopnea syndrome (OSAHS) in children and influencing factors of enuresis with OSAHS.MethodsWe recruited 196 children ≥5 years old from the otolaryngology outpatient department, who experienced snoring and underwent nasopharynx lateral radiography and in-laboratory polysomnography. We analyzed correlations between the apnea–hypopnea index (AHI) and lowest oxygen saturation (L-SaO2) with age, body mass index (BMI), tonsil size, and adenoidal–nasopharyngeal (A/N) ratio using the Pearson correlation test. Differences in severe OSAHS prevalence, age, AHI, L-SaO2, tonsil size, and A/N ratio between children with and without enuresis were assessed using the chi-square test and t-test. Risk factors of enuresis were analyzed using logistic regression. Follow-up was conducted to assess remission in children with enuresis after adenotonsillectomy.ResultsBMI, tonsil size, and A/N ratio were correlated with AHI and L-SaO2. Severe OSAHS prevalence, AHI, tonsil size, and A/N ratio were higher and L-SaO2 were lower in children with enuresis. Logistic regression showed that BMI, AHI, tonsil size, and sleep apnea were risk factors for enuresis.ConclusionsOur study findings showed that enuresis was associated with OSAHS in children. Adenotonsillectomy may improve the symptoms of enuresis.     

Efficacy and safety of human urinary kallidinogenase for acute ischemic stroke: a meta-analysis

ObjectiveHuman urinary kallidinogenase (HUK) is a glycoprotein extracted from human urine that is used to treat stroke by triggering positive regulation of the kallikrein–kinin system. Our aim was to evaluate the efficacy and safety of HUK treatment for acute ischemic stroke.MethodsWe searched the online databases PubMed, Embase, Cochrane Library, Google Scholar, and China National Knowledge Infrastructure (CNKI) for papers published between January 2015 and December 2019. The quality of each trial was assessed using the Cochrane Reviewers’ Handbook. Randomized controlled trials of HUK in patients with acute ischemic stroke were included.ResultsSixteen trials with 1326 participants were included. The HUK injection groups had more neurological improvement than the control groups in National Institutes of Health Stroke Scale scores (mean difference, –1.65; 95% confidence interval [CI], –2.12 to –1.71) and clinical efficacy (1.30; 95% CI, 1.21 to 1.41). Subgroup analysis indicated that age may influence heterogeneity. Eleven trials reported adverse effects and there were no significant differences between the control and HUK groups (risk difference, 0.01; 95% CI, –0.02 to 0.04).ConclusionsHUK ameliorates neurological symptoms in stroke patients with few adverse effects. Further high-quality, large-scale randomized trials are needed to confirm these results.     

Retrospective analysis of comorbidities in stroke patients with a history of obstructive sleep apnea treated with thrombolytic therapy

BackgroundThe eligibility criteria for thrombolytic therapy may differ between acute ischemic stroke patients (AIS) patients with and without incidence of obstructive sleep apnea (OSA). In this study, we determine the effect of specific comorbidities in the exclusion and inclusion for recombinant tissue plasminogen activator (rtPA) administration in the AIS population with OSA.MethodsRetrospective data from a stroke registry were analyzed for baseline clinical and demographic factors in AIS patients with OSA for rtPA therapy from January 2010 to June 2016. The logistic regression model was developed to identify each of the variables predicting inclusion for or exclusion from rtPA. We estimated the odds of the inclusion or exclusion of a particular demographic and clinical risk factor in AIS with and without OSA for rtPA therapy. The validity of the model was tested using a Hosmer-Lemeshow test and the sensitivity of the model was determined using a Receiver Operating Curve (ROC).ResultsA total of 170 AIS patients with OSA were identified, of which, 125 did not receive rtPA while 45 received rtPA. Adjusted analysis showed that in the AIS population with OSA, administration of rtPA was associated with a history of dyslipidemia (OR=3.192, 95% CI, 1.148-8.88, p=0.026), direct admission into a Comprehensive Stroke Center (OR=3.248, 95% CI, 1.06-9.95, p=0.039), and ambulatory improvement (OR=3.556, 95% CI, 1.428-8.86, p=0.006). There were no significant factors associated with rtPA exclusion in the AIS population with OSA.ConclusionThe prevalence of OSA in our AIS population was low and no clinical risk factor was associated with the exclusion of patients with AIS and OSA from thrombolytic therapy. Future studies are necessary to explore the effect of OSA in AIS patients to improve eligibility for rtPA therapy for more patients.     

Malnutrition on admission increases the in‐hospital mortality and length of stay in elder adults with acute ischemic stroke

PurposeMalnutrition, as determined by the Controlling Nutritional Status (CONUT), has an effect on the 3‐month and long‐term prognosis of stroke patients. The association between malnutrition and in‐hospital mortality has not been well established. We aimed to investigate the relationship between the CONUT score on admission and in‐hospital mortality and length of stay (LOS) in elderly patients with acute ischemic stroke (AIS).MethodsThis study analyzed controls and patients with AIS. Malnutrition was determined using the CONUT score. A CONUT score of 5–12 was defined as undernutrition status. Based on the CONUT scores, the patients were divided into the low CONUT (0–4) and high CONUT (5–12) groups.ResultsIn total, 1079 participants were recruited, comprising 288 controls and 791 AIS patients. Among the 791 patients, 64 (8.1%) had malnutrition and 63 (7.9%) had an in‐hospital death. Compared to the controls, the AIS patients presented higher CONUT scores, higher proportion of in‐hospital mortality (8.0%), and longer length of stay. Malnutrition was independently associated with in‐hospital mortality in the AIS patients (adjusted odds ratio: 3.77, 95% confidence interval [CI]: 1.55–9.15; p = 0.003). The general linear models showed an association between the CONUT score and LOS (β = 0.574, 95% CI: 0.208–0.934; p = 0.002). Furthermore, the effect of the interaction between infection and nutrition status on in‐hospital mortality showed borderline statistical significance (p = 0.06).ConclusionsMalnutrition estimated by the CONUT score on admission can be a predictor of in‐hospital mortality and increased LOS in elderly AIS patients.     

Case report of new-onset obstructive sleep apnea after carbon monoxide poisoning

Obstructive sleep apnea (OSA) is characterized by repetitive intermittent oxygen desaturation during sleep. Carbon monoxide poisoning (COP) is the second most common cause of death among non-medicinal poisonings, and oxygen therapy is the current standard of treatment for COP. We herein report a case of a 50-year-old woman diagnosed with severe OSA associated with COP. Both the OSA and COP gradually resolved by automatic continuous positive airway pressure (CPAP) therapy. New OSA symptoms appeared following the development of delayed encephalopathy after acute COP (DEACMP) 3 weeks later. Severe OSA was diagnosed 76 days after COP with an apnea–hypopnea index of 66 events/hour, and CPAP therapy was immediately administered. The patient’s DEACMP symptoms and OSA both improved with CPAP therapy (her apnea–hypopnea index decreased to 32.4 and 16.5 events/hour at 161 and 204 days after COP, respectively). To our knowledge, this is the first case report of OSA caused by COP based on the occurrence and disappearance of OSA symptoms and laboratory findings associated with the emergence and improvement of DEACMP.     

Gender disparity in a cohort of stroke patients with incidence of obstructive sleep apnea

BackgroundDifferences in baseline clinical risk factors have been proposed to contribute to gender differences in stroke outcome, how these clinical risk factors contribute to gender difference in acute ischemic stroke (AIS) patients with obstructive sleep apnea is yet to be fully investigated. This study explored the clinical characteristics associated with gender differences in AIS population with a baseline obstructive sleep apnea(OSA).MethodsA retrospective study was conducted using data from 5469 patients with an ischemic stroke event from a regional stroke center collected from January 2010 to June 2016. Multivariate logistic regression was used to determine factors associated with gender differences in the obstructive sleep apnea-ischemic stroke population.ResultsA total of 170 AIS patients presented with a baseline OSA, and 101 were men and 69 were women. In the AIS with OSA (AIS-OSA) population, patients presenting with peripheral vascular disease (PVD) (OR = 4.892, 95% CI,1.248 – 19.2, P = 0.023), depression (OR = 3.804, 95% CI, 1.369 – 10.6, P = 0.01), higher BMI (OR = 1.103, 95% CI, 1.036 – 1.18, P = 0.002), and higher HDL levels (OR = 1.125, 95% CI, 1.067 – 1.19, P = < 0.001) were associated with increasing odds of being women, and no clinical risk factor was associated with men AIS-OSA patients.ConclusionA gender specific difference was observed in pre-stroke demographic and risk factors for AIS patients with OSA. Women AIS patients with OSA were more likely to present with PVD and depression and have higher HDL and BMI levels when compared to men within the same population. In addition, more men AIS presented with OSA when compared with women AIS patients. Further studies to explore management strategies to eliminate gender differences will improve outcomes for men and women AIS with OSA.     

Identifying errors and safety considerations in patients undergoing thrombolysis for acute ischemic stroke

Background & purposeAlteplase is the standard of care for early pharmacologic thrombolysis after acute ischemic stroke (AIS). Alteplase is also considered a high-alert medication and is fraught with potential for error. We sought to describe the difference in medication error rates in in patients receiving alteplase for acute ischemic stroke from regional hospitals compared to patients receiving alteplase at the Comprehensive Stroke Center.MethodsThis was a retrospective cohort comparison of patients who were greater than 18 years old that received intravenous alteplase for the treatment of AIS from June 2015 to June 2018. Several institution specific databases were utilized to obtain pertinent data. A standardized taxonomy was utilized to classify medication errors. Patients were excluded if they received any fibrinolytic other than alteplase or if alteplase was used for a non-stroke indication. Two cohorts (from regional hospitals or the Comprehensive Stroke Center (CSC)) were compared.ResultsA total of 676 patients received alteplase during the study period (34% from the CSC and 66% from regional hospitals). There were 133 (19.8%) errors identified. Ten errors (1.6%) occurred at the CSC and 123 (18.2%) errors occurred at regional hospitals. More patients who had an error with alteplase administration (12.7%) experienced a hemorrhagic conversion compared to those with no error in administration (7.2%, p = 0.04).ConclusionThe error rate of alteplase infusion for ischemic stroke is high, particularly in patients from referring centers. Errors may be associated with adverse events. Further education and administration safeguards should be implemented to decrease the risk of medication errors.     

Impaired Visual Emotion Recognition After Minor Ischemic Stroke

ObjectiveTo assess the prevalence of impaired visual emotion recognition in patients who have experienced a minor ischemic stroke in the subacute phase and to determine associated factors of impaired visual emotion recognition.DesignA prospective observational study.SettingStroke unit of a teaching hospital.ParticipantsPatients with minor ischemic stroke (N=112).InterventionsNot applicable.Main Outcome MeasuresPatients with minor stroke underwent a neuropsychological assessment in the subacute phase for visual emotion recognition by the Ekman 60 Faces Test and for general cognition. Univariable linear regression analyses were performed to identify associated factors of emotion recognition impairment.ResultsIn 112 minor stroke patients, we found a prevalence of 25% of impaired visual emotion recognition. This was significantly correlated with impaired general cognition. Nevertheless, 10.9% of patients with normal general cognition still had impaired emotion recognition. Mood was negatively associated. Stroke localization, hemisphere side, and sex were not associated.ConclusionImpaired visual emotion recognition is found in about one-quarter of patients with minor ischemic stroke.     

Effect of early enteral nutrition on critical care outcomes in patients with acute ischemic stroke

ObjectiveStroke-associated pneumonia (SAP) is a comorbidity of ischemic stroke related to clinical outcomes. Early enteral nutrition (EEN; within 48 hours) reduces the incidence of infection and length of intensive care unit (ICU)/hospital stay. The relationship between EEN and critical care outcomes, including SAP, in patients with ischemic stroke has been insufficiently studied.MethodsWe recruited 499 patients in this retrospective observational study. We evaluated SAP incidence within 14 days from admission. Patients were divided into an EEN group and a late EN group (LEN; start later than EEN). We compared groups regarding background and length of ICU/hospital stay.ResultsEN was started within 48 hours in 236 patients. SAP was diagnosed in 94 patients (18.8%), with most in the LEN group (28.1% vs. 8.5%). Median [interquartile range] lengths of hospitalization (22 [12–30] days vs. 35 [20–45] days) and ICU stay (4 [2–5] days vs. 6 [3–8] days) were longer in the LEN group. EEN reduced the incidence of SAP. By contrast, consciousness disturbance and worsening consciousness level increased the SAP incidence. Increased age and National Institutes of Health Stroke Scale score were associated with start of prolonged EN.ConclusionsWe found that EEN may reduce SAP risk.     

三维斑点追踪技术评价阻塞型睡眠呼吸暂停低通气综合征伴高血压患者左心室整体收缩功能

目的 应用三维斑点追踪（3D-STI）技术评价阻塞型睡眠呼吸暂停低通气综合征（OSAHS）伴高血压（HT）患者左心室整体收缩功能。方法 OSAHS 40例,分为单纯OSAHS组20例和OSAHS+HT组20例;另选择20名健康正常人作为正常对照组。行常规超声心动图检查,采集左心室心尖四腔三维全容积图像,存储图像并应用3D-STI分析软件在线分析,计算左心室整体纵向收缩峰值应变（GLS）、左心室整体径向收缩峰值应变（GRS）、左心室整体圆周收缩峰值应变（GCS）及左心室整体面积收缩峰值应变（GAS）。结果 与正常对照组相比,OSAHS组 左心室GLS、GRS、GAS减低（P均<0.05）,OSAHS+HT组左心室GLS、GRS、GCS、GAS均减低（P均<0.05）。与OSAHS组比较,OSAHS+HT组 左心室GLS、GCS、GAS均减低（P均<0.05）。结论 OSAHS合并HT患者存在左心室收缩功能受损。3D-STI能早期、准确有效地评估其左心室整体收缩功能改变。OSAHS患者心脏结构及功能变化独立于HT而单独存在,二者同时存在时改变加重。     

Tumor metastasis has a significant relationship with the development of acute ischemic stroke in Chinese cancer patients: a retrospective study

ObjectiveThis study was designed to analyze the relationship between tumor metastasis and acute ischemic stroke (AIS) in Chinese cancer patients.MethodsThis retrospective study included 119 cancer patients with AIS and 152 cancer patients without AIS. Basic information was collected and tumor metastasis status was determined for all patients.ResultsThe whole cohort had a median age of 59 (49–69) years with 150 men (55.4%). There were 98 patients (36.2%) with tumor metastasis. Patients with AIS had significantly more males, tumor metastasis, lung cancer, hypertension, diabetes mellitus, higher age, D-dimer, international normalized ratio, prothrombin time, prothrombin activity, and thrombin time, while they had significantly lower levels of hemoglobin, red blood cells, and hematocrit. In multivariate logistic regression analysis, AIS was significantly and positively associated with age, tumor metastasis, D-dimer, and thrombin time. In multivariate Cox regression analysis, tumor metastasis, AIS, D-dimer, thrombin time, and fibrinogen were significantly and positively associated with worse prognosis.ConclusionsThis study demonstrates that tumor metastasis was positively and independently associated with AIS in Chinese cancer patients, suggesting that tumor metastasis has a significant relationship with the development of AIS. Additionally, tumor metastasis and AIS had negative independent effects on the prognosis of patients.     

急性脑卒中合并不同程度阻塞性睡眠呼吸暂停低通气综合征患者伴发脑心综合征的临床分析

目的探讨急性脑卒中合并不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生脑心综合征(CCS)的差异性,为临床监测及干预治疗提供依据。方法收集急性脑卒中合并OSAHS患者471例,其中缺血性卒中伴轻度OSAHS组85例,缺血性卒中伴中度OSAHS组74例,缺血性卒中伴重度OSAHS组68例,出血性卒中伴轻度OSAHS组69例,出血性卒中伴中度OSAHS组83例,出血性卒中伴重度OSAHS组92例。观察各组心电图、心肌酶、肌钙蛋白的变化。结果缺血性脑卒中合并不同程度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=6.532,P=0.012),其中两两比较差异均有统计学意义(P0.01)。出血性脑卒中合并不同程度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=12.741,P=0.005),其中两两比较差异均有统计学意义(P0.01)。缺血性卒中合并轻度OSAHS与出血性卒中合并轻度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=6.972,P=0.010)。缺血性卒中合并中度OSAHS与出血性卒中合并中度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=9.248,P=0.005)。缺血性卒中合并重度OSAHS与出血性卒中合并重度OSAHS患者发生CCS的比较,差异有统计学意义(χ~2=10.831,P=0.005)。结论急性脑卒中合并OSAHS的患者,随着OSAHS程度的加重,CCS的发生率增加,且出血性卒中合并OSAHS的患者较缺血性卒中合并OSAHS的患者更易导致CCS的发生。     

Clinical value of serum JKAP in acute ischemic stroke patients

BackgroundJun N‐terminal kinase pathway‐associated phosphatase (JKAP) regulates neuronal function, T helper (Th) 1/2/17 cell differentiation, and inflammatory process, but its clinical role in acute ischemic stroke (AIS) patients remains unclear. Hence, this study intended to evaluate JKAP level and its relationship with disease severity, Th1, 2, 17 secreted cytokines, adhesion molecules, and prognosis of AIS patients.MethodsSerum JKAP of 122 AIS patients and 50 controls was detected by ELISA. For AIS patients only, Th1, 2, 17 secreted cytokines IFN‐γ, IL‐4, IL‐17; TNF‐α, ICAM‐1, and VCAM‐1 were also detected by ELISA.ResultsJKAP was decreased in AIS patients compared with controls (46.350 (interquartile range (IQR): 34.250–59.875) pg/ml vs. 84.500 (IQR: 63.175–113.275) pg/ml, p < 0.001), which could distinguish AIS patients from controls (area under curve (AUC): 0.810, 95% confidence interval (CI): 0.732–0.888). In AIS patients, JKAP negatively linked with the National Institutes of Health Stroke Scale (NIHSS) score (r_s  = −0.342, p < 0.001); besides, it was positively related to IL‐4 (r_s  = 0.213, p = 0.018) and negatively associated with IL‐17 (r_s  = −0.270, p = 0.003) but not related to IFN‐γ (r_s  = −0.146, p = 0.109). Furthermore, elevated JKAP associated with declined TNF‐α (r_s  = −0.219, p = 0.015) and ICAM‐1 (r_s  = −0.235, p = 0.009) but not related to VCAM‐1 (r_s  = −0.156, p = 0.085). Besides, declined JKAP was linked with 2‐year recurrence (p = 0.027) and 3‐year recurrence (p = 0.010) in AIS patients; while JKAP was not related to 1‐year recurrence or death risk (both p > 0.050).ConclusionJKAP may sever as a candidate prognostic biomarker in AIS patients, indicating its potency for AIS management.     

Thrombectomy for distal medium vessel occlusion with a new generation of Stentretriever (Tigertriever 13)

PurposeTo evaluate the safety and efficacy of the Tigertriever 13 (Rapid Medical, Yoqneam, Israel) stent retriever in acute ischemic stroke (AIS) patients with primary or secondary distal, medium vessel occlusions (DMVO).MethodsWe performed a retrospective analysis of all consecutive AIS patients who underwent thrombectomy with the Tigertriever13 for DMVO. Patients’ characteristics were reviewed, procedural complications, angiographic (modified thrombolysis in cerebral infarction score [mTICI]) and clinical (modified Rankin Scale [mRS]) outcomes were documented.ResultsBetween November 2019 and November 2020, 16 patients with 17 DMVO were included (40% female, median age 60 [50–65] years). The Tigertriever13 was used in 11/17 (65%, median NIHSS of 8 [6–15]) primary DMVO and in 6/17 (35%, median NIHSS of 20 [13–24]) cases of secondary DMVO after a proximal thrombectomy. The successful reperfusion rate (mTICI 2b, 2c, 3) was 94% (16/17) for the dedicated vessel. At day 1, CT imaging showed a subarachnoid hemorrhage in 29% of the cases and a parenchymal hematoma in 12%. At 3 months, 65% of the patients (11/17) had a favorable outcome (mRS 0–2).ConclusionMechanical thrombectomy using the Tigertriever13 appears to be safe and effective for DMVO. Clinical and anatomical results are in line with those of patients with proximal occlusions.     

Plasma expression of HIF-1α as novel biomarker for the diagnosis of obstructive sleep apnea-hypopnea syndrome

BackgroundObstructive sleep apnea‐hypopnea syndrome (OSAHS) is a common breathing disorder during sleep with potential lethality and multi‐complications. Polysomnography (PSG) is now the golden standard for the diagnosis obstructive sleep apnea‐hypopnea syndrome. However, PSG is expensive and time‐consuming. Therefore, it is important to find inexpensive and convenient biomarkers for the diagnosis of OSAHS.ObjectiveThe present study aimed to explore the potential diagnostic value of HIF‐1α for OSAHS and its clinical significance.MethodsThis study consisted of 368 patients admitted to the sleep laboratory. The patients were classified according to their apnea‐hypopnea index (AHI) scores as OSA negative (AHI < 5), mild‐moderate (AHI:5‐30), and severe OSA (AHI > 30), and severe OSA treated with continuous positive airway pressure (CPAP). qRT‐PCR was used to detect mRNA levels in the plasma; Pearson''s correlation analysis was performed to analyze the correlation of HIF‐1α mRNA level and the clinicopathological factors of OSAHS; ROC curve was constructed to evaluate the diagnostic value of HIF‐1α mRNA.ResultsHIF‐1α mRNA was significantly up‐regulated in the plasma of OSAHS patients, especially patients with severe OSAHS. HIF‐1α mRNA was positively correlated with the AHI and ODI but negatively correlated with the mean oxygen saturation in patients with OSAHS. Results of ROC curve showed that HIF‐1α is a sensitive biomarker for the diagnosis of OSAHS, especially severe OSAHS.ConclusionsHIF‐1α mRNA might be used as s a convenient and inexpensive method for triaging OSAHS patients PSG assessment in the hospital and evaluate the curative effect.     

阻塞型睡眠呼吸暂停低通气综合征患者海马MRS参数与认知功能的相关性

目的 探讨阻塞型睡眠呼吸暂停低通气综合征（OSAHS）患者海马MRS成像参数与认知功能之间的相关性。方法 对31例OSAHS患者（OSAHS组）及28名健康志愿者（对照组）行单体素MRS检查,检测双侧海马NAA、Cho和Cr峰值,计算NAA/Cr、Cho/Cr、NAA/Cho;采用蒙特利尔认知评估量表（MoCA）和简易智能状态量表（MMSE）评估认知功能,分析双侧海马NAA/Cr、Cho/Cr、NAA/Cho与MoCA、MMSE评分间的相关性。结果 OSAHS组双侧海马Cho/Cr较对照组增高,NAA/Cho较对照组减低（P均<0.05）,NAA/Cr差异无统计学意义（P均>0.05）。OSAHS患者双侧海马Cho/Cr与MoCA、MMSE评分呈负相关（P均<0.05）,NAA/Cho与MMSE评分呈正相关（P均<0.05）。结论 OSAHS患者双侧海马MRS参数与认知功能相关,可作为OSAHS患者认知功能损害的神经影像学标记。     

Overexpression of sirtuin 2 and its association with prognosis in acute ischemic stroke patients

BackgroundThis study aimed to investigate the correlation of sirtuin 2 (SIRT2) with acute ischemic stroke (AIS) risk, severity, inflammation, and prognosis.MethodsA hundred and sixty‐four first episode AIS patients and 164 age and gender matched non‐AIS patients with high‐stroke‐risk factors (controls) were enrolled. Peripheral blood was collected and serum was separated for SIRT2 and pro‐inflammatory cytokines detection by enzyme‐linked immunosorbent assay. AIS patients were continually followed up to 36 months or death, then recurrence‐free survival (RFS) and overall survival (OS) were calculated.ResultsSerum SIRT2 expression was increased in AIS patients compared to controls (p < 0.001), then receiver operative characteristic curve disclosed that the serum SIRT2 expression could differentiate AIS patients from controls with a good area under curve of 0.890 (95%CI: 0.854–0.926), a sensitivity of 78.7% and a specificity of 91.5% at the best cut‐off point. Serum SIRT2 expression was positively correlated with National Institute of Health stroke scale score (p < 0.001), serum tumor necrosis factor‐α (p < 0.001), interleukin (IL)‐6 (p = 0.012) and IL‐17 (p < 0.001) expressions in AIS patients. In addition, serum SIRT2 expression was elevated in recurrent/dead AIS patients compared to non‐recurrent/dead AIS patients (p = 0.025), and was also increased in dead AIS patients compared to survivors (p = 0.006). Moreover, RFS (p = 0.029) and OS (p = 0.049) were both worse in AIS patients with SIRT2 high expression compared to AIS patients with SIRT2 low expression.ConclusionSIRT2 may serve as a marker for AIS risk and prognosis in clinical practice.