Circulating cell-free DNA is a predictor of short-term neurological outcome in stroke patients treated with intravenous thrombolysis
Bustamante, Alejandro (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Mancha, Fernando (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Macher, Hada C. (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
García-Berrocoso, Teresa (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Giralt, Dolors (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ribo, Marc (Hospital Universitari Vall d'Hebron)
Guerrero, Juan M. (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Montaner, Joan (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Data:	2016
Resum:	Circulating cell-free DNA (cfDNA) has been described as a prognostic marker for several diseases. Its prognostic value for short-term outcome in stroke patients treated with intravenous thrombolysis remains unexplored. cfDNA was measured on admission in 54 tissue plasminogen activator (tPA)-treated patients and 15 healthy controls using a real-time quantitative polymerase chain reaction assay. Neurological outcome was assessed at 48 h. Predictors of neurological improvement were evaluated by logistic regression analysis, and the additional predictive value of cfDNA over clinical variables was determined by integrated discrimination improvement (IDI). Stroke patients presented higher baseline cfDNA than healthy controls (408. 5 (179-700. 5) vs. 153. 5 (66. 9-700. 5) kilogenome-equivalents/L, p = 0. 123). A trend towards lower cfDNA levels was found in patients who neurologically improved at 48 h (269. 5 (143. 3-680) vs. 504 (345. 9-792. 3) kilogenome-equivalents/L, p = 0. 130). In logistic regression analysis, recanalization at 1 h and cfDNA < 302. 75 kilogenome-equivalents/L was independently associated with neurological improvement after adjustment by age, gender and baseline National Institutes of Health Stroke Scale score. The addition of cfDNA to the clinical predictive model improved its discrimination (IDI = 21. 2% (9. 2-33. 3%), p = 0. 009). These data suggest that cfDNA could be a surrogate marker for monitoring tPA efficacy by the prediction of short-term neurological outcome.
Ajuts:	Instituto de Salud Carlos III FIS PI15-354 Instituto de Salud Carlos III CM13/00265
Nota:	Altres ajuts: This work has been funded by Instituto de Salud Carlos III, grant FIS PI15/354, co-financed by the European Regional Development Fund (FEDER). AB is supported by a Rio Hortega contract CM13/00265 from the Instituto de Salud Carlos III.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Stroke ; Biomarkers ; Circulating DNA ; Thrombolysis ; Outcome ; Neurological improvement
Publicat a:	Journal of Circulating Biomarkers, Vol. 5 (september 2016) , ISSN 1849-4544

DOI: 10.1177/1849454416668791
PMID: 28936264

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