title: Neopterin as a Predictor of Functional Outcome and Mortality in Chinese Patients with Acute Ischemic Stroke.
abstract: Immune responses and inflammation play an important role in the pathogenesis of ischemic stroke. We therefore evaluated the 6-month prognostic value of early measurement of serum neopterin levels, a marker of inflammation and immune system activation, in Chinese patients with acute ischemic stroke (AIS). Consecutive AIS patients admitted to the emergency department were identified. Clinical information was collected. Serum concentration of neopterin and NIH stroke scale (NIHSS) were measured at the time of admission. Functional outcome was measured by modified Rankin scale (mRS) 6 months after admission. Multivariate analyses were performed using logistic regression models. During the inclusion period, 312 patients with first-ever AIS were included and 290 completed follow-up. The results indicated that the serum neopterin levels were significantly (P < 0.0001) higher in acutely ischemic stroke patients as compared to normal controls. Neopterin was an independent prognostic marker of 6-month functional outcome and death [odds ratio (OR) 4.33 (1.83-10.32) and 6.68 (2.44-12.13), respectively, P < 0.0001 for both, adjusted for NIHSS, other predictors and vascular risk factors] in patients with AIS. Neopterin improved the area under the receiver operating characteristic curve of the NHISS score for functional outcome from 0.75 (95 % CI 0.69-0.83) to 0.85 (95 % CI 0.79-0.91; P < 0.001) and for mortality from 0.76 (95 % CI 0.68-0.85) to 0.87 (95 % CI 0.81-0.94; P < 0.001). Serum neopterin is a useful, independent tool to predict functional outcome and mortality 6 months after stroke.
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China. zengxwei@163.com.
authors.forename: Xianwei
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China.
authors.forename: Linpeng
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Ni
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, The Affiliated Hospital of Weifang Medical College, 2428 Yuhe Road, Weifang, Shandong, 261031, China.
authors.forename: Yumeng
authors.initials: Y
authors.lastname: Luo
mesh_terms: D000208:Acute Disease; D000368:Aged; D044466:Asian People; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019798:Neopterin / Q000097:blood*; D020521:Stroke / Q000097:blood* / Q000150:complications* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D019798:Neopterin
keywords: Ischemic stroke; Marker; Neopterin; Prognosis