BACKGROUND AND PURPOSE: The prediction of death or disability ("poor outcome") after stroke by validated clinical models might be improved by the addition of blood biomarker measurements. We investigated whether such measurements improved the classification of patients into 4 categories of predicted risk of poor outcome: very high, intermediate high, intermediate low, and very low. METHODS: We prospectively recruited symptomatic patients within 24 hours of ischemic cerebrovascular events. We measured clinical prognostic variables in each patient. We drew blood soon after admission and measured markers of inflammation, thrombosis, cardiac strain, and cerebral damage. We assessed poor outcome at 3 months with the modified Rankin Scale and recovery of symptoms at 24 hours. We measured the association between blood marker levels and poor outcome after adjustment for stroke severity and age with multivariate logistic regression. Where these associations were statistically significant, we calculated the net reclassification index. RESULTS: We recruited 270 patients with acute ischemic cerebrovascular events. At 3 months, 112 patients had a poor outcome. After adjustment for stroke severity and age, only interleukin-6 and N-terminal pro-brain natriuretic peptide were significantly associated with poor outcome. The addition of either interleukin-6 or N-terminal pro-brain natriuretic peptide to National Institutes of Health Stroke Scale and age did not improve the prediction of a poor outcome. CONCLUSIONS: Neither interleukin-6 nor N-terminal pro-brain natriuretic peptide had sufficient predictive power to be of clinical use to predict poor outcome after stroke. The search for better markers to improve the classification of patients across clinically relevant boundaries of predicted probabilities of outcome events needs to continue.
BACKGROUND AND PURPOSE: The prediction of death or disability ("poor outcome") after stroke by validated clinical models might be improved by the addition of blood biomarker measurements. We investigated whether such measurements improved the classification of patients into 4 categories of predicted risk of poor outcome: very high, intermediate high, intermediate low, and very low. METHODS: We prospectively recruited symptomatic patients within 24 hours of ischemic cerebrovascular events. We measured clinical prognostic variables in each patient. We drew blood soon after admission and measured markers of inflammation, thrombosis, cardiac strain, and cerebral damage. We assessed poor outcome at 3 months with the modified Rankin Scale and recovery of symptoms at 24 hours. We measured the association between blood marker levels and poor outcome after adjustment for stroke severity and age with multivariate logistic regression. Where these associations were statistically significant, we calculated the net reclassification index. RESULTS: We recruited 270 patients with acute ischemic cerebrovascular events. At 3 months, 112 patients had a poor outcome. After adjustment for stroke severity and age, only interleukin-6 and N-terminal pro-brain natriuretic peptide were significantly associated with poor outcome. The addition of either interleukin-6 or N-terminal pro-brain natriuretic peptide to National Institutes of Health Stroke Scale and age did not improve the prediction of a poor outcome. CONCLUSIONS: Neither interleukin-6 nor N-terminal pro-brain natriuretic peptide had sufficient predictive power to be of clinical use to predict poor outcome after stroke. The search for better markers to improve the classification of patients across clinically relevant boundaries of predicted probabilities of outcome events needs to continue.
Authors: Lenka Kielbergerová; Otto Mayer; Jiří Vaněk; Jan Bruthans; Peter Wohlfahrt; Renata Cífková Journal: Transl Stroke Res Date: 2015-08-15 Impact factor: 6.829
Authors: Johnathan de Sousa Parreira; Ana Paula Kallaur; Marcio Francisco Lehmann; Sayonara Rangel Oliveira; Daniela Frizon Alfieri; Daniela Alfieri Frizon; Francieli Delongui; Franceili Delongui; Maria Caroline Martins de Araújo; Carolina Rossato; Jessica Tavares de Almeida; Larissa Muliterno Pelegrino; Erick Frank Bragato; Helena Kaminami Morimoto; Andrea Name Colado Simão; Damacio Ramon Kaimen-Maciel; Edna Maria Vissoci Reiche Journal: Metab Brain Dis Date: 2014-07-27 Impact factor: 3.584
Authors: Lara A Boyd; Kathryn S Hayward; Nick S Ward; Cathy M Stinear; Charlotte Rosso; Rebecca J Fisher; Alexandre R Carter; Alex P Leff; David A Copland; Leeanne M Carey; Leonardo G Cohen; D Michele Basso; Jane M Maguire; Steven C Cramer Journal: Int J Stroke Date: 2017-07 Impact factor: 5.266
Authors: Marcio Francisco Lehmann; Ana Paula Kallaur; Sayonara Rangel Oliveira; Daniela Frizon Alfieri; Franciele Delongui; Johnathan de Sousa Parreira; Maria Caroline Martins de Araújo; Carolina Rossato; Jéssica Tavares de Almeida; Larissa Moliterno Pelegrino; Erick Frank Bragato; Ana Lucia Cruz Fürstenberger Lehmann; Helena Kaminami Morimoto; Marcell Alysson Batisti Lozovoy; Andrea Name Colado Simão; Damácio Ramon Kaimen-Maciel; Edna Maria Vissoci Reiche Journal: Metab Brain Dis Date: 2015-09-11 Impact factor: 3.584
Authors: W T Longstreth; Richard A Kronmal; John L P Thompson; Robert H Christenson; Steven R Levine; Rebecca Gross; Robin L Brey; Richard Buchsbaum; Mitchell S V Elkind; David L Tirschwell; Stephen L Seliger; J P Mohr; Christopher R deFilippi Journal: Stroke Date: 2013-01-22 Impact factor: 7.914