title: Immuno-inflammatory activation in acute cardio-embolic strokes in comparison with other subtypes of ischaemic stroke.
abstract: Few studies have examined the relationship between inflammatory biomarker blood levels, cardioembolic stroke subtype and neurological deficit. So the aim of our study is to evaluate plasma levels of immuno-inflammatory variables in patients with cardio-embolic acute ischaemic stroke compared to other diagnostic subtypes and to evaluate the relationship between immuno-inflammatory variables, acute neurological deficit and brain infarct volume. One hundred twenty patients with acute ischaemic stroke and 123 controls without a diagnosis of acute ischaemic stroke were evaluated. The type of acute ischaemic stroke was classified according to the TOAST classification. We evaluated plasma levels of IL-1beta, TNF-alpha, IL-6 and IL-10, E-selectin, P-selectin, sICAM-1,sVCAM-1, vWF, TPA and PAI-1. Patients with ischaemic stroke classified as cardio-embolic (CEI) showed, compared to other subtypes, significantly higher median plasma levels of TNF-alpha , IL-6 and IL-1beta. Furthermore stroke patients classified as lacunar showed, compared to other subtypes, significantly lower median plasma levels of TNF-alpha, IL-6 and IL-1beta. Multiple linear regression showed a significant association between the Scandinavian Stroke Scale (SSS) score at admission and diagnostic subtype, infarct volume of cardio-embolic strokes and some inflammatory variables. Our findings confirm that cardio-embolic strokes have a worse clinical presentation and produce larger and more disabling strokes than other ischaemic stroke subtypes reporting a possible explanation of higher immuno-inflammatory activation of the acute phase.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Pizza delle Cliniche n.2, 90127 Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Licata
authors.forename: Antonino
authors.initials: A
authors.lastname: Tuttolomondo
authors.forename: Domenico
authors.initials: D
authors.lastname: Di Raimondo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Corrao
authors.forename: Riccardo
authors.initials: R
authors.lastname: Di Sciacca
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000276:immunology* / Q000473:pathology; D016022:Case-Control Studies; D004185:Disability Evaluation; D004617:Embolism / Q000150:complications / Q000276:immunology*; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000276:immunology*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D020521:Stroke / Q000276:immunology* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha