Immune-Inflammatory, Metabolic, Oxidative, and Nitrosative Stress Biomarkers Predict Acute Ischemic Stroke and Short-Term Outcome.
Daniela Frizon AlfieriMarcio Francisco LehmannTamires FlauzinoMaria Caroline Martins de AraújoNicolas PivotoRafaele Maria TirollaAndrea Name Colado SimãoMichael MaesEdna Maria Vissoci ReichePublished in: Neurotoxicity research (2020)
Immune-inflammatory, metabolic, oxidative, and nitrosative stress (IMO&NS) pathways and, consequently, neurotoxicity are involved in acute ischemic stroke (IS). The simultaneous assessment of multiple IMO&NS biomarkers may be useful to predict IS and its prognosis. The aim of this study was to identify the IMO&NS biomarkers, which predict short-term IS outcome. The study included 176 IS patients and 176 healthy controls. Modified Rankin scale (mRS) was applied within 8 h after IS (baseline) and 3 months later (endpoint). Blood samples were obtained within 24 h after hospital admission. IS was associated with increased white blood cell (WBC) counts, high sensitivity C-reactive protein (hsCRP), interleukin (IL-6), lipid hydroperoxides (LOOHs), nitric oxide metabolites (NOx), homocysteine, ferritin, erythrocyte sedimentation rate (ESR), glucose, insulin, and lowered iron, 25-hydroxyvitamin D [25(OH)D], total cholesterol, and high-density lipoprotein (HDL) cholesterol. We found that 89.4% of the IS patients may be correctly classified using the cumulative effects of male sex, systolic blood pressure (SBP), glucose, NOx, LOOH, 25(OH)D, IL-6, and WBC with sensitivity of 86.2% and specificity of 93.0%. Moreover, increased baseline disability (mRS ≥ 3) was associated with increased ferritin, IL-6, hsCRP, WBC, ESR, and glucose. We found that 25.0% of the variance in the 3-month endpoint (mRS) was explained by the regression on glucose, ESR, age (all positively), and HDL-cholesterol, and 25(OH)D (both negatively). These results show that the cumulative effects of IMO&NS biomarkers are associated with IS and predict a poor outcome at 3-month follow-up.
Keyphrases
- blood pressure
- end stage renal disease
- nitric oxide
- ejection fraction
- acute ischemic stroke
- newly diagnosed
- dengue virus
- chronic kidney disease
- type diabetes
- low density lipoprotein
- healthcare
- heart failure
- left ventricular
- emergency department
- multiple sclerosis
- stem cells
- reactive oxygen species
- ms ms
- skeletal muscle
- peripheral blood
- adipose tissue
- mesenchymal stem cells
- bone marrow
- acute care
- patient reported
- clinical evaluation