Abstract T P184: The Importance of Blood Biomarkers in Penetrating Artery Territory Infarction; A Prospective Multicenter Observational Study
Objective: Neurological deterioration in penetrating artery territory infarction (PATI) is unpredictable and associated with a worse clinical outcome. This study aimed to determine the importance of blood biomarkers to predict neurological deterioration and long-term clinical outcome.
Methods: From November 2012 to December 2013, we performed a prospective multicenter observational study of PATI patients presenting within 2 days of stroke onset. Blood samples were obtained within 24h after admission (1st point) and on a day between 6th and 8th hospitalization (2nd point) for several biomarkers. Symptomatic progression (SP) was defined as the increase of at least one point on the National Institutes of Health Stroke Scale. Favorable outcome was defined as modified Rankin Scale score≤2 at 90 days after ictus.
Results: 25 patients (28%) showed SP in evaluated 90 patients (35 men with a mean age of 70.4 years). The patients with SP were significantly (p<0.05) more elderly, hypertensive, clinically severed than those without SP on admission.
At 1st point, the patients with SP had significantly higher serum IL-6 and lower CD34 levels as compared to those without SP (IL-6: 4.8 [2.3-7.95] vs 2.4[1.3-4.1] pg/ml (p=0.007) and CD34: 0.5 [0.31-0.88] vs 0.8[0.49-1.08] /μL (p=0.002)).
Moreover, the patients with poor outcome at 90 days had significantly higher serum IL-6 levels, higher TNF-alpha levels and lower CD34 levels as compared to those with favorable outcome. At 2nd point, the patients with poor outcome had significantly higher serum IL-6 levels, higher TNF-alpha levels, higher pro-adrenomedullin levels, and lower ADAMTS13 levels compared to those with favorable outcome .
Comparing the change of biomarker levels between two-point measurements, the significant increases of pro-adrenomedullin and oxidized LDL receptor-1, and decrease of ADAMTS13 were correlated with SP.
Conclusions: Blood biomarkers of inflammatory and endothelial function might be valuable to predict symptomatic progression and poor long-term outcome in PATI, meaning the surrogate markers for treatment evaluation in future stroke trials.
Author Disclosures: T. Kawano: None. K. Miyashita: None. M. Takeuchi: None. N. Metoki: None. Y. Akaiwa: None. Y. Yamamoto: None. Y. Manabe: None. K. Toyoda: None. K. Nagatuka: None.
- © 2015 by American Heart Association, Inc.