title: Role of N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and inteleukin-6 in predicting a poor outcome after a stroke.
abstract: OBJECTIVE
  N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6) concentrations can be important biomarkers in the acute stroke setting. In acute ischemic and hemorrhagic stroke patients, we investigated the association of NT-proBNP, hsCRP, and IL-6 serum concentrations with stroke severity and functional and cognitive outcomes at discharge.
  
  
  METHODS
  Seventy-eight patients (53 men; median age 72 years) admitted with ischemic or hemorrhagic stroke within 48 h of symptom onset were evaluated for clinical stroke severity (Scandinavian stroke scale; SSS), functional status before the stroke (modified Rankin scale; mRS), and cerebrovascular disease risk factors. Cognitive (Mini Mental State Examination) and functional (mRS) outcomes were evaluated at hospital discharge. Blood samples were drawn for the assessment of NT-proBNP, hsCRP, and IL-6 concentrations within 24 h of admission.
  
  
  RESULTS
  Greater NT-proBNP and hsCRP serum concentrations were associated with greater clinical stroke severity, adjusting for the patients' gender, age, stroke type, mRS score on admission, and presence of heart failure (β = -0.292, p = 0.012; β = -0.303, p = 0.009). In multivariate adjusted regression models with IL-6, hsCRP, and NT-proBNP considered together, IL-6 and hsCRP remained associated with worse functional (β = 0.210, p = 0.022) and cognitive (β = -0.269, p = 0.014) outcomes at discharge, respectively. In receiver operating characteristic analyses, the investigated blood biomarkers produced a minimal increase in predictive values for outcomes at discharge above the SSS score, age, and gender.
  
  
  CONCLUSIONS
  In acute stroke patients, greater NT-proBNP and hsCRP serum concentrations are independently associated with greater clinical stroke severity. Elevated concentrations of IL-6 and hsCRP are associated with worse functional and cognitive outcomes at discharge, respectively.
authors.affiliation: Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Adomas
authors.initials: A
authors.lastname: Bunevicius
authors.forename: Henrikas
authors.initials: H
authors.lastname: Kazlauskas
authors.forename: Nijole
authors.initials: N
authors.lastname: Raskauskiene
authors.forename: Narseta
authors.initials: N
authors.lastname: Mickuviene
authors.forename: Rudina
authors.initials: R
authors.lastname: Ndreu
authors.forename: Elena
authors.initials: E
authors.lastname: Corsano
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevicius
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism*; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D017063:Outcome Assessment, Health Care; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000150:complications / Q000175:diagnosis
chemical_list: D015850:Interleukin-6; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein