title: Prognostic value of inflammatory mediators in 1-year outcome of acute ischemic stroke with middle cerebral artery stenosis.
abstract: OBJECTIVE
  Inflammation exists in inception, progression, and reperfusion of acute ischemic stroke. Insightful understanding of correlation in inflammatory mediators and stroke severity with intracranial artery stenosis may improve rational stroke therapy.
  
  
  METHODS
  We prospectively recruited 977 patients with acute noncardioembolic ischemic stroke with MCA stenosis by MRA as none to mild (<50%), moderate (50-69%), severe (70-99%), or occlusive (100%). The peripheral levels of WBC, homocysteine (HCY), and high sensitivity C-reactive protein (hs-CRP) were recorded. All patients were assessed of 1-year outcome by mRS as favorable (0-2) or poor (3-6).
  
  
  RESULTS
  The levels of WBC, HCY, and hs-CRP had no significant differences in patients with categorized MCA stenosis (all P > 0.05). Higher levels of WBC, HCY, and hs-CRP were found in patients with 1-year poor outcome (all P < 0.05), but only hs-CRP is an independent predictor (OR 1.06, 95% CI 1.027-1.093, P = 0.0003). The combination of any two of increased hs-CRP (>3 mg/L), WBC (>6.91 × 10(9)/L), and HCY (>15  μ mol/L) had higher power in predicting 1-year poor outcome than the single elevated mediator.
  
  
  CONCLUSIONS
  Elevated hs-CRP independently predicts 1-year poor outcome in acute stroke. The combination of increased hs-CRP, WBC, or HCY had a stronger predictive value in poor outcome than individual elevated mediator.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Gong
authors.forename: Xinying
authors.initials: X
authors.lastname: Zou
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Pu
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.forename: Yannie O Y
authors.initials: YO
authors.lastname: Soo
authors.forename: Thomas W H
authors.initials: TW
authors.lastname: Leung
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein
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