Elevated plasma CD147 levels at admission were associated with higher odds of cognitive impairment at 3 months after stroke among patients with acute ischemic stroke, suggesting its potential role in the pathophysiological processes of PSCI.
Key Findings
Results
Elevated plasma CD147 levels were significantly associated with higher odds of post-stroke cognitive impairment (PSCI) after multivariate adjustment.
Odds ratio of 1.75 (95% CI, 1.21–2.51) for PSCI as defined by Mini-Mental State Examination (MMSE)
Study included 612 patients with ischemic stroke with plasma CD147 levels measured at admission
PSCI was defined as MMSE score <27 or Montreal Cognitive Assessment (MoCA) score <25
Logistic regression models were used to assess the association after multivariate adjustment
Similar findings were observed when PSCI was defined by the Montreal Cognitive Assessment
Results
317 out of 612 participants developed PSCI as defined by the Mini-Mental State Examination at 3-month follow-up.
This represents approximately 51.8% of the study population developing PSCI
Cognitive function was evaluated at the 3-month follow-up visit
Both MMSE and MoCA were used as assessment tools
Participants were drawn from a preplanned ancillary study of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke)
Results
A linear association was found between plasma CD147 level and PSCI in the restricted cubic spline analysis.
P for linearity = 0.038 in the multiple-adjusted spline regression model
Restricted cubic spline analyses were used alongside logistic regression models to assess the association
The linear relationship suggests a dose-response pattern between CD147 levels and cognitive impairment risk
Results
Adding plasma CD147 to conventional risk factors significantly improved the discriminatory power for predicting PSCI.
C statistics improved from 0.695 (conventional risk factors alone) to 0.711 (with CD147 added)
The improvement in C statistics was statistically significant (P = 0.047)
This finding suggests CD147 provides incremental predictive value beyond standard clinical risk factors
Background
CD147 is described as a multifunctional transmembrane glycoprotein whose effect on post-stroke cognitive impairment was previously unclear.
CD147 (Cluster of Differentiation 147) is the biomarker investigated in this study
Plasma levels were measured at hospital admission following acute ischemic stroke
The study is framed as addressing a gap in knowledge regarding CD147's role in PSCI pathophysiology
The trial was registered at ClinicalTrials.gov (NCT01840072)
What This Means
This research suggests that a protein called CD147, measured in the blood shortly after a stroke, may be linked to the development of cognitive problems (such as memory and thinking difficulties) three months later. In a study of 612 stroke patients in China, those with higher levels of CD147 in their blood at the time of hospital admission were about 1.75 times more likely to develop cognitive impairment by the three-month follow-up, even after accounting for other known risk factors. More than half of participants (317 out of 612) developed post-stroke cognitive impairment, highlighting how common this complication is.
The researchers also found that the relationship between CD147 levels and cognitive impairment risk was linear — meaning higher CD147 levels were associated with progressively greater risk. Importantly, adding CD147 measurements to conventional risk factors modestly but statistically significantly improved the ability to identify which patients would go on to develop cognitive problems, suggesting it could serve as a useful early biomarker.
This research suggests that CD147 may play a role in the biological processes that lead to cognitive decline after stroke. If confirmed in future studies, measuring CD147 at the time of stroke admission could help clinicians identify patients who are at higher risk of developing thinking and memory problems, potentially enabling earlier intervention or monitoring. However, further research is needed to understand the mechanisms involved and whether targeting CD147 could be a therapeutic strategy.
Zhao W, Sun L, Zan J, Zheng X, Zhou J, Yang X, et al.. (2026). Plasma Cluster of Differentiation 147 and Cognitive Impairment After Acute Ischemic Stroke.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.048033