Prognostic Value of Plasma Neuroendocrine Biomarkers in Patients with Acute Ischaemic Stroke

被引:150
作者
Tu, W. -J. [1 ,2 ]
Dong, X. [3 ]
Zhao, S. -J. [4 ]
Yang, D. -G. [1 ,2 ]
Chen, H. [5 ]
机构
[1] Capital Med Univ, China Rehabil Res Ctr, Beijing, Peoples R China
[2] Capital Med Univ, Sch Rehabil Med, Beijing, Peoples R China
[3] Dalian Med Univ, Affiliated Hosp 1, Dept Neurol, Dalian, Peoples R China
[4] China Rehabil Res Ctr, Dept Neurol, Beijing, Peoples R China
[5] China Rehabil Res Ctr, Inst Rehabil Sci China, Beijing, Peoples R China
基金
中国国家自然科学基金;
关键词
acute ischaemic stroke; prognostic; neuroendocrine; biomarker; BRAIN NATRIURETIC PEPTIDE; C-REACTIVE PROTEIN; COPEPTIN; MORTALITY; EVENTS; MARKER; DEATH;
D O I
10.1111/jne.12052
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Inflammation and activation of the neuroendocrine systems comprise important aspects of stroke pathophysiology. The present study investigated whether baseline plasma brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-proBNP), cortisol and copeptin levels on admission can predict short-term outcomes and mortality after acute ischaemic stroke. The study group consisted of 189 patients who had their first acute ischaemic stroke. Plasma levels of BNP, NT-proBNP, cortisol and copeptin were evaluated to determine their value with respect to predicting functional outcome and mortality within 3months. As a result of cardiovascular and neurological investigations (including imaging techniques), lesion size, stroke subtype classification and clinical outcome after 3months were determined. Plasma levels of BNP, NT-proBNP, cortisol and copeptin were associated with stroke severity, as well as short-term functional outcomes. After adjusting for all other significant outcome predictors, NT-proBNP, cortisol and copeptin remained as independent outcome predictors. In the receiver operating characteristic curve analysis, the biomarker panel (including BNP, NT-proBNP, cortisol and copeptin) predicted functional outcome and death within 90days significantly more efficiently than the National Institute of Health Stroke Scale (NIHSS) or the biomarker alone. Copeptin showed a significantly greater discriminatory ability as a single biomarker compared to BNP, NT-proBNP, cortisol and NIHSS score. These results suggest that a biomarker panel may add valuable and time-sensitive prognostic information in the early evaluation of acute ischaemic stroke. This may provide a channel for interventional therapy in acute stroke.
引用
收藏
页码:771 / 778
页数:8
相关论文
共 39 条
[1]   Baseline NIH Stroke Scale score strongly predicts outcome after stroke - A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST) [J].
Adams, HP ;
Davis, PH ;
Leira, EC ;
Chang, KC ;
Bendixen, BH ;
Clarke, WR ;
Woolson, RF ;
Hansen, MD .
NEUROLOGY, 1999, 53 (01) :126-131
[2]   CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].
ADAMS, HP ;
BENDIXEN, BH ;
KAPPELLE, LJ ;
BILLER, J ;
LOVE, BB ;
GORDON, DL ;
MARSH, EE ;
KASE, CS ;
WOLF, PA ;
BABIKIAN, VL ;
LICATAGEHR, EE ;
ALLEN, N ;
BRASS, LM ;
FAYAD, PB ;
PAVALKIS, FJ ;
WEINBERGER, JM ;
TUHRIM, S ;
RUDOLPH, SH ;
HOROWITZ, DR ;
BITTON, A ;
MOHR, JP ;
SACCO, RL ;
CLAVIJO, M ;
ROSENBAUM, DM ;
SPARR, SA ;
KATZ, P ;
KLONOWSKI, E ;
CULEBRAS, A ;
CAREY, G ;
MARTIR, NI ;
FICARRA, C ;
HOGAN, EL ;
CARTER, T ;
GURECKI, P ;
MUNTZ, BK ;
RAMIREZLASSEPAS, M ;
TULLOCH, JW ;
QUINONES, MR ;
MENDEZ, M ;
ZHANG, SM ;
ALA, T ;
JOHNSTON, KC ;
ANDERSON, DC ;
TARREL, RM ;
NANCE, MA ;
BUDLIE, SR ;
DIERICH, M ;
HELGASON, CM ;
HIER, DB ;
SHAPIRO, RA .
STROKE, 1993, 24 (01) :35-41
[3]   Neurohormonal activation in ischemic stroke: Effects of acute phase disturbances on long-term mortality [J].
Anne, Makikallio ;
Juha, Korpelainen ;
Timo, Makikallio ;
Mikko, Tulppo ;
Olli, Vuolteenaho ;
Kyosti, Sotaniemi ;
Heikki, Huikuri ;
Vilho, Myllyla .
CURRENT NEUROVASCULAR RESEARCH, 2007, 4 (03) :170-175
[4]  
[Anonymous], 2000, Bmj, V320
[5]   RECOVERY OF MOTOR FUNCTION AFTER STROKE [J].
BONITA, R ;
BEAGLEHOLE, R .
STROKE, 1988, 19 (12) :1497-1500
[6]   The global stroke initiative [J].
Bonita, R ;
Mendis, S ;
Truelsen, T ;
Bogousslavsky, J ;
Toole, J ;
Yatsu, F .
LANCET NEUROLOGY, 2004, 3 (07) :391-393
[7]   MEASUREMENTS OF ACUTE CEREBRAL INFARCTION - LESION SIZE BY COMPUTED-TOMOGRAPHY [J].
BROTT, T ;
MARLER, JR ;
OLINGER, CP ;
ADAMS, HP ;
TOMSICK, T ;
BARSAN, WG ;
BILLER, J ;
EBERLE, R ;
HERTZBERG, V ;
WALKER, M .
STROKE, 1989, 20 (07) :871-875
[8]   Acute blood glucose level and outcome from ischemic stroke [J].
Bruno, A ;
Biller, J ;
Adams, HP ;
Clarke, WR ;
Woolson, RF ;
Williams, LS ;
Hansen, MD .
NEUROLOGY, 1999, 52 (02) :280-284
[9]   Blood levels of glutamate oxaloacetate transaminase are more strongly associated with good outcome in acute ischaemic stroke than glutamate pyruvate transaminase levels [J].
Campos, Francisco ;
Rodriguez-Yanez, Manuel ;
Castellanos, Mar ;
Arias, Susana ;
Perez-Mato, Maria ;
Sobrino, Tomas ;
Blanco, Miguel ;
Serena, Joaquin ;
Castillo, Jose .
CLINICAL SCIENCE, 2011, 121 (1-2) :11-17
[10]  
Czlonkowska A, 1997, ACTA NEUROL SCAND, V95, P121