calca-protein--human and Brain-Ischemia

The aim of the study was to assess the relationship between procalcitonin (PCT) serum levels and acute ischemic stroke (AIS) in a Chinese sample. All consecutive patients with first-ever AIS between January 2012 and December 2013 were recruited to participate in the study. PCT levels and National Institutes of Health Stroke Scale scores were evaluated at the time of admission. Logistic regression analysis was used to evaluate the risk for stroke according to serum PCT levels. The results indicated that serum PCT levels were significantly higher in AIS patients as compared with normal controls (P<0.0001). PCT levels increased with increasing severity of stroke, as defined by the National Institutes of Health Stroke Scale score. After adjusting for all other possible covariates, PCT level was found to be associated with an increased risk for AIS, with an adjusted odds ratio of 2.244 (95% confidence interval 1.563-3.756, P<0.0001). On the basis of the receiver operating characteristic curve, the optimal cutoff value of serum PCT levels as an indicator for auxiliary diagnosis of AIS was projected to be 1.20 ng/ml, which yielded a sensitivity of 79.6% and a specificity of 72.1%, with the area under the curve at 0.801 (95% confidence interval 0.762-0.844). An elevated serum level of PCT was a novel, independent diagnostic marker of AIS in the Chinese sample. Further study is needed to confirm these results.

Topics: Aged; Biomarkers; Brain Ischemia; Calcitonin; Calcitonin Gene-Related Peptide; China; Female; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Protein Precursors; Risk; ROC Curve; Sensitivity and Specificity; Severity of Illness Index; Stroke

The aim of this study is to assess the prognostic value of systemic inflammation, as measured by the inflammatory biomarkers PCT and Hs-CRP, to predict the long-term mortality in ischemic stroke patients.. We prospectively studied 374 patients with ischemic stroke who were admitted within 24h after the onset of symptoms. Serum levels of PCT, Hs-CRP and NIH stroke scale (NIHSS) were measured at the time of admission. Clinical follow-up was performed at 1 year. The prognostic value of PCT to predict the mortality within one year was compared with Hs-CRP, NIHSS and with other known outcome predictors.. In the 64 non-survival patients, serum PCT levels were significantly (P<0.0001) higher compared with those in survival patients. Multivariate COX regression analysis showed that log-transformed PCT and Hs-CRP were independent mortality predictors with adjusted hazard ratio of 4.24 (95% confidence interval [CI], 2.42-6.30) and 15.37 (95% confidence interval [CI], 3.25-41.08). The area under the receiver operating characteristic curve of PCT and Hs-CRP were 0.89 (95% CI, 0.85-0.93) and 0.68 (95% CI, 0.59-0.77) for mortality, respectively.. Serum levels of PCT and HS-CRP at admission were independent predictor of long-term mortality after ischemic stroke in a Chinese sample.

Topics: Aged; Aged, 80 and over; Biomarkers; Brain Ischemia; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Female; Follow-Up Studies; Humans; Male; Middle Aged; Predictive Value of Tests; Prognosis; Prospective Studies; Protein Precursors; Severity of Illness Index; Stroke; Time Factors

The role and impact of systemic inflammatory response after aneurysmal subarachnoid hemorrhage remain to be elucidated.. To assess the time course and correlation of systemic inflammatory parameters with outcome and the occurrence of delayed ischemic neurological deficits (DINDs) after subarachnoid hemorrhage.. Besides the baseline characteristics, daily interleukin-6 (IL-6), procalcitonin, C-reactive protein levels, and leukocyte counts were prospectively measured until day 14 after subarachnoid hemorrhage. Occurrence of infectious complications and application of therapeutic hypothermia were assessed as confounding factors. The primary end point was outcome after 3 months, assessed by Glasgow outcome scale; the secondary end point was the occurrence of DINDs.. During a 3-year period, a total of 138 patients were included. All inflammatory parameters measured were higher in patients with unfavorable outcome (Glasgow outcome scale score, 1-3). After adjustment for confounding factors, elevated IL-6 and leukocyte counts remained significant risk factors for unfavorable outcome. The odds ratio for log IL-6 was 4.07 (95% confidence interval, 1.18 to 14.03; P = .03) and for leukocyte counts was 1.24 (95% confidence interval, 1.06-1.46, P = .008). The analysis of the time course established that IL-6 was the only significantly elevated parameter in the early phase in patients with unfavorable outcome. Higher IL-6 levels in the early phase (days 3-7) were associated with the occurrence of DINDs. The adjusted odds ratio for log IL-6 was 4.03 (95% confidence interval, 1.21-13.40; P = .02).. Higher IL-6 levels are associated with worse clinical outcome and the occurrence of DINDs. Because IL-6 levels were significantly elevated in the early phase, they might be a useful parameter to monitor.

Topics: Adult; Aged; Biomarkers; Brain Ischemia; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Cerebral Angiography; Confidence Intervals; Endpoint Determination; Female; Glasgow Outcome Scale; Humans; Hypothermia, Induced; Inflammation; Interleukin-6; Leukocyte Count; Logistic Models; Male; Middle Aged; Nervous System Diseases; Odds Ratio; Prospective Studies; Protein Precursors; ROC Curve; Sample Size; Subarachnoid Hemorrhage; Treatment Outcome

Early predictors for the development of stroke-associated infection may identify patients at high risk and reduce post-stroke infection and mortality.. In 383 prospectively enrolled acute stroke patients we assessed time point and type of post-stroke infections (i.e. pneumonia, urinary tract infection (UTI) other infection (OI)). Blood samples were collected on admission, and days 1, and 3 to assess white blood cells (WBC), monocytes, C-reactive protein (CRP), procalcitonin (PCT), and copeptin. To determine the magnitude of association with the development of infections, odds ratios (OR) were calculated for each prognostic blood marker. The discriminatory ability of different predictors was assessed, by calculating area under the receiver operating characteristic curves (AUC). Prognostic models including the three parameters with the best performance were identified.. Of 383 patients, 66 (17.2%) developed an infection after onset of stroke. WBC, CRP, copeptin and PCT were all independent predictors of any infection, pneumonia and UTI developed at least 24 hours after measurements. The combination of the biomarkers WBC, CRP and copeptin (AUC: 0.92) and WBC, CRP and PCT (AUC: 0.90) showed a better predictive accuracy concerning the development of pneumonia during hospitalization compared to each marker by itself (p-Wald <0.0001).. Among ischemic stroke patients, copeptin, PCT, WBC and CRP measured on admission were predictors of infection in general, and specifically for pneumonia and UTI within 5 days after stroke. The combination of these biomarkers improved the prediction of patients who developed an infection.

Topics: Aged; Area Under Curve; Biomarkers; Brain Ischemia; Calcitonin; Calcitonin Gene-Related Peptide; Female; Glycopeptides; Humans; Infections; Inflammation; Male; Odds Ratio; Prognosis; Protein Precursors; Stroke