title: Soluble CXCL16 and long-term outcome in acute ischemic stroke.
abstract: OBJECTIVE
  CXCL16 is a chemokine involved in atherosclerosis by promoting inflammation, lipid accumulation and matrix degradation. The level of circulating CXCL16 has been proposed as a predictor of long-term mortality in acute coronary syndromes. We studied plasma CXCL16 in acute ischemic stroke and examined associations with long-term mortality following the acute event.
  
  
  METHODS
  CXCL16 samples were obtained from 244 patients with acute ischemic stroke (age: 69±13 years) daily from presentation to day 5 and at half a year after the stroke. Patients with overt ischemic heart disease and atrial fibrillation were excluded. The patients were followed for 47 months, with all-cause and cardiovascular (CV) mortality as end-points.
  
  
  RESULTS
  At follow-up, 72 patients had died with 43 due to CV causes. Plasma CXCL16 was stably elevated in the first days after the acute event followed by a marked decrease after 6 months. In patients who subsequently suffered an adverse outcome, CXCL16 levels at 4 days after the initial event were elevated and were moderately associated with mortality. The increase in CXCL16 from day 1 to 4 was a predictor for all-cause and, in particular, CV mortality even after adjustment in the multivariate analysis for established risk factors such as age, the presence of heart/renal failure, troponin, C-reactive protein and stroke severity.
  
  
  CONCLUSIONS
  An increase in plasma CXCL16 during the first days after the initial event is associated with an adverse outcome in patients with acute ischemic stroke, supporting the potential pathogenic role of CXCL16 in atherosclerosis and vascular remodelling as well as their major clinical consequences.
authors: Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway. thor.ueland@medisin.uio.no
authors: T
authors: T
authors: Ueland
authors: L M
authors: LM
authors: Smedbakken
authors: J
authors: J
authors: Hallén
authors: D
authors: D
authors: Atar
authors: J L
authors: JL
authors: Januzzi
authors: B
authors: B
authors: Halvorsen
authors: J K
authors: JK
authors: Jensen
authors: P
authors: P
authors: Aukrust
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000276:immunology / Q000401:mortality; D000075743:Chemokine CXCL16; D019743:Chemokines, CXC / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051116:Receptors, Scavenger / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000276:immunology / Q000401:mortality; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C423727:CXCL16 protein, human; D000075743:Chemokine CXCL16; D019743:Chemokines, CXC; D051116:Receptors, Scavenger