Background
Thromboinflammatory molecules connect the prothrombotic state, endothelial dysfunction,
and systemic/local inflammation in the acute phase of ischemic stroke.
Methods
We prospectively investigated (1) serial changes in the levels of thromboinflammatory
biomarkers in 76 patients with acute ischemic stroke (6, 24, and 72 hours after onset);
(2) compared with 44 patients with asymptomatic severe (≥70%) carotid stenosis and
66 patients with Parkinson disease; and (3) we applied multiple regression methods,
relating biological biomarkers combined with demographic data and comorbidities to
poststroke infection, death, and functional outcome, and assessed the ability of the
models to predict each outcome.
Results
Interleukin 6 (IL-6) levels and change of IL-6 concentrations by 72 hours correlated
with the size of tissue damage indicated by S100B titers. Levels of IL-6 and P-selectin
at 72 hours were higher in patients with large-artery versus lacunar stroke. High
concentration of IL-6, monocyte chemotactic protein 1, and S100B at 6 hours were associated
with poststroke infections; high concentration of IL-6, S100B, and high-sensitivity
C-reactive protein (hsCRP) correlated with death. Change of P-selectin from 6 to 72 hours
by 1 unit increased the incidence of poststroke infections with an odds ratio of 22.7;
each 100 units of IL-6 at baseline increased the odds of death by 9‰, and at 72 hours,
the odds of poststroke infections by 4‰. Each unit of baseline hsCRP elevated the
odds of death by 7%.
Conclusions
In regression models, in which biological, demographic, and comorbid factors were combined,
those biological biomarkers predicted poor outcome with high accuracy, which were
characterized by an increasing concentration by 72 hours. Two particular biomarkers
emerged to predict outcomes besides hsCRP: early dynamic changes in the systemic levels
of P-selectin and IL-6.
Key Words
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Article info
Publication history
Published online: June 04, 2015
Accepted:
May 6,
2015
Received in revised form:
April 22,
2015
Received:
February 12,
2015
Footnotes
Z.I. received grant from Hungarian National Research Fund (OTKA K77892).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.05.005
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
