Abstract
OBJECTIVES: To investigate the relationship between plasma hydrogen sulfide (H(2)S) levels and collateral circulation in patients with acute ischemic stroke (AIS), and to explore the effects of vascular endothelial growth factor (VEGF), homocysteine (Hcy), folic acid (FA), vitamin B(12) (VB(12)), and vitamin B(6) (VB(6)). METHODS: A total of 68 AIS patients were enrolled and classified into two groups based on collateral vessel grading: the Good Collateral Circulation (GCC) group (n = 37) and the Poor Collateral Circulation (PCC) group (n = 31). Plasma levels of H(2)S, VEGF, Hcy, FA, VB(12), and VB(6) were measured on the 2(nd) and 7(th) days after admission using microassays and ELISA. RESULTS: Compared to the PCC group, patients in the GCC group had significantly lower National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale scores (mRS) scores at both admission and discharge (all P < 0.05). On both the 2(nd) and 7(th) days, plasma levels of H(2)S, VEGF, FA, VB(12), and VB(6) were significantly higher in the GCC group, while Hcy levels were significantly lower (all P < 0.05). Within group comparisons between the two time points also showed significant changes (all P < 0.001). Correlation analysis revealed that plasma H(2)S levels were positively correlated with collateral circulation, VEGF, FA, VB(12), and VB(6), and negatively correlated with Hcy levels (all P < 0.001). Plasma H(2)S levels demonstrated high predictive value for collateral circulation (area under the curve, AUC = 0.943). An interaction between time and collateral circulation on H(2)S levels was also observed. CONCLUSIONS: Plasma H(2)S levels may serve as a valuable biomarker for predicting good collateral circulation in patients with acute ischemic stroke.