Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
Ramiro, Laura (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Abraira del Fresno, Laura (Universitat Autònoma de Barcelona. Departament de Medicina)
Quintana, Manuel (Universitat Autònoma de Barcelona. Departament de Medicina)
García-Rodríguez, Paula (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Santamarina, Estevo (Universitat Autònoma de Barcelona. Departament de Medicina)
Álvarez Sabín, José (Universitat Autònoma de Barcelona. Departament de Medicina)
Zaragoza, Josep (Hospital de Tortosa Verge de la Cinta)
Hernández-Pérez, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ustrell, Xavier (Hospital Universitari Joan XXIII de Tarragona)
Lara-Rodríguez, Blanca (Hospital Universitari de Bellvitge)
Terceño, Mikel (Hospital Universitari de Girona Doctor Josep Trueta)
Bustamante, Alejandro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Montaner, Joan (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Fecha:	2021
Resumen:	Stroke is a major cause of disability and death globally, and prediction of mortality represents a crucial challenge. We aimed to identify blood biomarkers measured during acute ischemic stroke that could predict long-term mortality. Nine hundred and forty-one ischemic stroke patients were prospectively recruited in the Stroke-Chip study. Post-stroke mortality was evaluated during a median 4. 8-year follow-up. A 14-biomarker panel was analyzed by immunoassays in blood samples obtained at hospital admission. Biomarkers were normalized and standardized using Z -scores. Multiple Cox regression models were used to identify clinical variables and biomarkers independently associated with long-term mortality and mortality due to stroke. In the multivariate analysis, the independent predictors of long-term mortality were age, female sex, hypertension, glycemia, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Independent blood biomarkers predictive of long-term mortality were endostatin > quartile 2, tumor necrosis factor receptor-1 (TNF-R1) > quartile 2, and interleukin (IL)-6 > quartile 2. The risk of mortality when these three biomarkers were combined increased up to 69%. The addition of the biomarkers to clinical predictors improved the discrimination (integrative discriminative improvement (IDI) 0. 022 (0. 007-0. 048), p < 0. 001). Moreover, endostatin > quartile 3 was an independent predictor of mortality due to stroke. Altogether, endostatin, TNF-R1, and IL-6 circulating levels may aid in long-term mortality prediction after stroke.
Ayudas:	Instituto de Salud Carlos III PI18-00804 Instituto de Salud Carlos III RD16-0019-0021 Instituto de Salud Carlos III IFI17-00012
Nota:	Altres ajuts: This work has been funded by La Fundació La Marató (Reg. 84/240 proj. 201702).
Derechos:	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, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Ischemic stroke ; Biomarker ; Mortality ; Endostatin ; IL-6 ; TNF-R1
Publicado en:	Life, Vol. 11 (february 2021) , ISSN 2075-1729

DOI: 10.3390/life11020135
PMID: 33578805

11 p, 1.2 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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