Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis

Background and Purpose. 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 recr...

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Main Authors: Xiping Gong, Xinying Zou, Liping Liu, Yuehua Pu, Yilong Wang, Yuesong Pan, Yannie O. Y. Soo, Thomas W. H. Leung, Xingquan Zhao, Yongjun Wang, Ka Sing Wong
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Mediators of Inflammation
Online Access:http://dx.doi.org/10.1155/2013/850714
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author Xiping Gong
Xinying Zou
Liping Liu
Yuehua Pu
Yilong Wang
Yuesong Pan
Yannie O. Y. Soo
Thomas W. H. Leung
Xingquan Zhao
Yongjun Wang
Ka Sing Wong
author_facet Xiping Gong
Xinying Zou
Liping Liu
Yuehua Pu
Yilong Wang
Yuesong Pan
Yannie O. Y. Soo
Thomas W. H. Leung
Xingquan Zhao
Yongjun Wang
Ka Sing Wong
author_sort Xiping Gong
collection DOAJ
description Background and Purpose. 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 . Higher levels of WBC, HCY, and hs-CRP were found in patients with 1-year poor outcome (all , but only hs-CRP is an independent predictor (OR 1.06, 95% CI 1.027–1.093, . The combination of any two of increased hs-CRP (>3 mg/L), WBC (>6.91 × 109/L), and HCY (>15 μmol/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.
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spelling doaj-art-d410df223a8b4f7aa3a13bf1e92c71b82025-08-20T02:19:45ZengWileyMediators of Inflammation0962-93511466-18612013-01-01201310.1155/2013/850714850714Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery StenosisXiping Gong0Xinying Zou1Liping Liu2Yuehua Pu3Yilong Wang4Yuesong Pan5Yannie O. Y. Soo6Thomas W. H. Leung7Xingquan Zhao8Yongjun Wang9Ka Sing Wong10Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDivision of Neurology, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaDivision of Neurology, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, ChinaDivision of Neurology, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, ChinaBackground and Purpose. 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 . Higher levels of WBC, HCY, and hs-CRP were found in patients with 1-year poor outcome (all , but only hs-CRP is an independent predictor (OR 1.06, 95% CI 1.027–1.093, . The combination of any two of increased hs-CRP (>3 mg/L), WBC (>6.91 × 109/L), and HCY (>15 μmol/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.http://dx.doi.org/10.1155/2013/850714
spellingShingle Xiping Gong
Xinying Zou
Liping Liu
Yuehua Pu
Yilong Wang
Yuesong Pan
Yannie O. Y. Soo
Thomas W. H. Leung
Xingquan Zhao
Yongjun Wang
Ka Sing Wong
Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis
Mediators of Inflammation
title Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis
title_full Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis
title_fullStr Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis
title_full_unstemmed Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis
title_short Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis
title_sort prognostic value of inflammatory mediators in 1 year outcome of acute ischemic stroke with middle cerebral artery stenosis
url http://dx.doi.org/10.1155/2013/850714
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