title: Prognostic Value of Inflammatory and Cardiovascular Biomarkers for Prediction of 90-Day All-Cause Mortality after Acute Ischemic Stroke-Results from the Linz Stroke Unit Study.
abstract: BACKGROUND
  Early outcome prediction after acute ischemic stroke is of great interest. The aim of our study was to evaluate the prognostic value of blood biomarkers in patients with acute ischemic stroke.
  
  
  METHODS
  We measured interleukin-6 (IL-6), d-dimer, amino-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T, and soluble ST2 plasma concentrations within 24 h after admission to our stroke unit in 721 consecutive acute ischemic stroke patients. End point was 90-day all-cause mortality.
  
  
  RESULTS
  During follow-up 81 patients died (11%). In univariate Cox proportional hazards regression analyses with the biochemical markers dichotomized according to median values, all baseline blood biomarkers were strong prognostic markers. However, in the multivariate analysis after adjustment for several clinical variables and the NIH Stroke Scale (NIHSS), only NIHSS >3 [risk ratio (RR) 7.87, 95% CI, 3.61-17.16;P< 0.001], IL-6 > 7 pg/mL (RR 4.09, 95% CI, 2.02-8.29;P< 0.001), and NT-proBNP >447 ng/L (RR 4.88, 95% CI, 2.41-9.88;P< 0.001) remained independent predictors. Using a simple multimarker approach combining these 3 complementary markers, we demonstrated that patients with increased NIHSS, IL-6, and NT-proBNP had the poorest outcome with a mortality rate of 38%, whereas no patient with negative readings for all 3 markers died during follow-up.
  
  
  CONCLUSIONS
  In this large cohort of patients with acute ischemic stroke, IL-6 and NT-proBNP at admission were strong and independent prognostic markers for 90-day all-cause mortality, and provided complementary prognostic information to the routinely used stroke severity score NIHSS.
authors.affiliation: Departments of Laboratory Medicine and benjamin.dieplinger@bs-lab.at.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dieplinger
authors.affiliation: Neurology, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
authors.forename: Christof
authors.initials: C
authors.lastname: Bocksrucker
authors.affiliation: Departments of Laboratory Medicine and.
authors.forename: Margot
authors.initials: M
authors.lastname: Egger
authors.affiliation: Neurology, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Eggers
authors.affiliation: Departments of Laboratory Medicine and.
authors.forename: Meinhard
authors.initials: M
authors.lastname: Haltmayer
authors.affiliation: Departments of Laboratory Medicine and.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mueller
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020521:Stroke / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D016019:Survival Analysis
chemical_list: D015415:Biomarkers