Serum neuron specific enolase level as a predictor of prognosis in acute ischemic stroke patients after intravenous thrombolysis

Objective: Serum neuron specific enolase (NSE) concentrations are significantly correlated with stroke severity and clinical outcome in ischemic stroke patients. We aimed to determine whether the serum levels of neuron specific enolase in acute ischemic stroke (AIS) patients after intravenous thrombolysis are associated with stroke severity, and indicative of favorable outcome. Methods: We prospectively analyzed the serum neuron specific enolase levels with for 67 subjects with AIS patients treated with intravenous recombinant tissue type plasminogen activator (rtPA) within 4.5 h from symptom onset. Neurologic deficit was assessed by the National Institutes of Health Stroke Scale. Clinical outcome was assessed after 90 days according to the modified Rankin Scale. Results: Neuron specific enolase levels correlated with National Institutes of Health Stroke Scale score 24 h after rtPA bolus (R = 0342, p = 0.005). Regarding the 67 included patients, 32 (47.8%) reached favorable outcome. They had a lower NIHSS score on admission (p = 0.000) and at 24 h after rtPA bolus (p = 0.000), and had lower levels of neuron specific enolase (p = 0.006). But only NIHSS score at 24 h after rtPA bolus rather than neuron specific enolase level was an independent predictor for favorable outcome. Conclusion: We found that after treatment with intravenous rtPA therapy, lower serum neuron specific enolase levels were associated with favorable outcome, which may be confounded by the link to NIHSS score. (C) 2015 Elsevier B.V. All rights reserved.