title: Inflammation markers and prediction of post-stroke vascular disease recurrence: the MITICO study.
abstract: OBJECTIVE
  Vascular disease recurrence following stroke is the main cause of morbidity and mortality. The MITICO study was designed to assess the prognostic value of markers of inflammation in relation to the risk of recurrence of vascular disease.
  
  
  METHODS
  Multi-centered prospective observational study, in patients with ischemic stroke not receiving anti-coagulation therapy and who were recruited within 1-3 months from stroke onset. Blood samples were obtained at baseline and follow- up for the determination of high-sensitive C reactive protein (CRP), IL-6, IL-10, ICAM-1, VCAM- 1, MMP-9 and cellular fibronectin. Four follow-up visits within the first year were to rule out recurrence.
  
  
  RESULTS
  Of 965 patients from 65 hospitals, 780 (aged 67.5+/-11.2 years, 33.6 % female) were valid for main analysis. One-hundred and three patients (13.2 %) had a new adverse vascular event and 116 patients (14.9 %) a vascular event or vascular death (66.4 % stroke, 21.5 % coronary and 12.1 % peripheral). Levels of IL-6 > 5 pg/mL and VCAM-1 > 1350 ng/mL (ROC curve analyses) were associated with vascular disease recurrence risk (OR: 28.7; 95 % CI: 14.2-58.0 vs. OR: 4.1; 95 % CI: 2.4-7.1, respectively) following adjustment for confounding variables. Risk of adverse vascular event or death from vascular disease were associated with IL-6 (OR: 21.2; 95 % CI: 11.6-38.7) and VCAM-1 (OR: 3.8; 95 % CI: 2.3-6.4).
  
  
  CONCLUSIONS
  Baseline values of IL-6 > 5 pg/mL and VCAM-1 > 1350 ng/mL increase 21-fold and 4-fold, respectively, the risk of new vascular disease event or death from vascular disease in patients with ischemic stroke not receiving anti-coagulation treatment.
authors.affiliation: Dept. of Neurology, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, 15706 Santiago de Compostela, A Coruña, Spain. mecasti@usc.es
authors.forename: J
authors.initials: J
authors.lastname: Castillo
authors.forename: J
authors.initials: J
authors.lastname: Alvarez-Sabín
authors.forename: E
authors.initials: E
authors.lastname: Martínez-Vila
authors.forename: J
authors.initials: J
authors.lastname: Montaner
authors.forename: T
authors.initials: T
authors.lastname: Sobrino
authors.forename: J
authors.initials: J
authors.lastname: Vivancos
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D020520:Brain Infarction / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism; D005260:Female; D005353:Fibronectins / Q000032:analysis / Q000097:blood; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis / Q000097:blood; D016753:Interleukin-10 / Q000032:analysis / Q000097:blood; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000032:analysis / Q000097:blood; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D019010:Vascular Cell Adhesion Molecule-1 / Q000032:analysis / Q000097:blood
chemical_list: D015415:Biomarkers; D005353:Fibronectins; D018836:Inflammation Mediators; D015850:Interleukin-6; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D016753:Interleukin-10; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9