title: Monocyte chemotactic protein-1 as a potential biomarker for early anti-thrombotic therapy after ischemic stroke.
abstract: Inflammation following ischemic brain injury is correlated with adverse outcome. Preclinical studies indicate that treatment with acetylsalicylic acid + extended-release dipyridamole (ASA + ER-DP) has anti-inflammatory and thereby neuroprotective effects by inhibition of monocyte chemotactic protein-1 (MCP-1) expression. We hypothesized that early treatment with ASA + ER-DP will reduce levels of MCP-1 also in patients with ischemic stroke. The EARLY trial randomized patients with ischemic stroke or TIA to either ASA + ER-DP treatment or ASA monotherapy within 24 h following the event. After 7 days, all patients were treated for up to 90 days with ASA + ER-DP. MCP-1 was determined from blood samples taken from 425 patients on admission and day 8. The change in MCP-1 from admission to day 8 did not differ between patients treated with ASA + ER-DP and ASA monotherapy (p > 0.05). Comparisons within MCP-1 baseline quartiles indicated that patients in the highest quartile (>217-973 pg/mL) showed improved outcome at 90 days if treated with ASA + ER-DP in comparison to treatment with ASA alone (p = 0.004). Our data does not provide any evidence that treatment with ASA + ER-DP lowers MCP-1 in acute stroke patients. However, MCP-1 may be a useful biomarker for deciding on early stroke therapy, as patients with high MCP-1 at baseline appear to benefit from early treatment with ASA + ER-DP.
authors.affiliation: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Worthmann
authors.affiliation: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dengler
authors.affiliation: Boehringer Ingelheim Pharma GmbH & Co. KG, Binger Str. 173, Ingelheim 55216, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Schumacher
authors.affiliation: Department of Neurology, Nordstadt Klinikum Hannover, Haltenhoffstr. 41, Hannover 30167, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwartz
authors.affiliation: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.|Institute of Biophysics, University of Hannover, Herrenhäuserstr. 2, Hannover 30419, Germany.
authors.forename: Wolfgang G
authors.initials: WG
authors.lastname: Eisert
authors.affiliation: Department of Clinical Chemistry, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Lichtinghagen
authors.affiliation: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Weissenborn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000188:drug therapy; D018932:Chemokine CCL2 / Q000097:blood*; D004176:Dipyridamole / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D020521:Stroke / Q000097:blood / Q000188:drug therapy; D013997:Time Factors
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D010975:Platelet Aggregation Inhibitors; D004176:Dipyridamole; D001241:Aspirin