Multiple atherosclerosis-related biomarkers associated with short- and long-term mortality after stroke.
OBJECTIVE
We investigated the relationships of biomarkers of various pathophysiologic pathways including high-sensitivity C-reactive protein (hs-CRP), lipocalin-2 (LCN2), myeloperoxidase (MPO) and matrix metalloproteinases 9 (MMP9) with mortality in stroke patients.


METHODS
hs-CRP, LCN2 and MPO concentrations in 92 patients were determined using enzyme-linked immunosorbent assays. MMP9 mRNA concentrations were determined using real-time quantitative reverse transcription-polymerase chain reaction.


RESULTS
Twelve patients (13.0%) died at 6 months and 34 patients (37.0%) died at 5 years. The independent predictors for 6-month mortality were hs-CRP (adjusted OR=16.0) and LCN2 (adjusted OR=16.9), while for 5-year mortality was hs-CRP (adjusted OR=5.56). For patients with hs-CRP >3.4 mg/L, an increase in LCN2 was associated with 2.5-fold higher 6-month mortality, while an increase in normalized MMP9 mRNA was associated with 5.8-fold higher 6-month and 1.5-fold higher 5-year mortality.


CONCLUSIONS
hs-CRP was the most significant independent predictor of both short- and long-term mortality after stroke, with LCN2 and MMP9 mRNA each adding further to the risk stratification.
Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Cangel Pui-yee
CP
Chan
Hui-lin
HL
Jiang
Ling-yan
LY
Leung
Wai-man
WM
Wan
Nga-man
NM
Cheng
Wai-sze
WS
Ip
Kwan-yee
KY
Cheung
Rebecca Wing-yan
RW
Chan
Lawrence Ka-sing
LK
Wong
Colin Alexander
CA
Graham
Reinhard
R
Renneberg
Timothy Hudson
TH
Rainer
D000209:Acute-Phase Proteins; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000401:mortality; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D020300:Intracranial Hemorrhages / Q000097:blood* / Q000401:mortality; D053208:Kaplan-Meier Estimate; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D015999:Multivariate Analysis; D009195:Peroxidase / Q000097:blood; D011518:Proto-Oncogene Proteins / Q000097:blood*; D012333:RNA, Messenger / Q000097:blood / Q000235:genetics; D012372:ROC Curve
D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D012333:RNA, Messenger; D002097:C-Reactive Protein; D009195:Peroxidase; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9