Abstract
INTRODUCTION: Using an Asian cohort with high prevalence of concomitant cerebrovascular disease (CeVD), we evaluated the performance of a plasma immunoassay for tau phosphorylated at threonine 217 (p-tau217) in detecting amyloid beta positivity (Aβ+) on positron emission tomography and cognitive decline, based on a three-range reference, which stratified patients into low-, intermediate-, and high-risk groups for Aβ+.
METHODS: Brain amyloid status (Aβ– [n = 142] vs Aβ+ [n = 73]) on amyloid PET scans was assessed along with the plasma ALZpath p-tau217 assay to derive three-range reference points for PET Aβ+ based on 90% sensitivity (lower threshold) and 90% specificity (upper threshold).
RESULTS: Plasma p-tau217 (area under the curve [AUC] = 0.923) outperformed routine clinical assessments (AUC=0.760–0.819; p≤0.003) and other plasma biomarkers (AUC = 0.817–0.834; p < 0.001). The high-risk group showed significantly higher rates of cognitive decline than the low-risk group.
DISCUSSION: Risk stratification for PET Aβ+ based on a plasma p-tau217 assay demonstrated potential diagnostic and prognostic utility in an Asian cohort with concomitant CeVD.
Full article: https://doi.org/10.1002/alz.14502
