Serum S-100B adds incremental value for the prediction of symptomatic intracranial hemorrhage and brain edema after acute ischemic stroke
Honegger, Tim (University Hospital Zurich (Suïssa))
Schweizer, Juliane (University Hospital Zurich (Suïssa))
Bicvic, Antonela (Inselspital University of Berne)
Westphal, Laura P (University Hospital Zurich (Suïssa))
Schütz, Valerie (University Hospital Zurich (Suïssa))
Inauen, Corinne (University Hospital Zurich (Suïssa))
Pokorny, Thomas (University Hospital Zurich (Suïssa))
Bracher, Katja (University Hospital Zurich (Suïssa))
Arnold, Marcel (Inselspital University of Berne)
Fischer, Urs (University Hospital Basel (Basilea, Suïssa))
Bonati, Leo (University Hospital Basel (Basilea, Suïssa))
De Marchis, Gian Marco (University Hospital Basel (Basilea, Suïssa))
Nedeltchev, Krassen (Kantonsspital Aarau (Aarau, Suïssa))
Kahles, Timo (Kantonsspital Aarau (Aarau, Suïssa))
Cereda, Carlo (Ospedale Regionale di Lugano)
Kägi, Georg (Kantonsspital St. Gallen)
Montaner, Joan (Hospital Universitari Vall d'Hebron)
Bustamante, Alejandro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Palà, Elena (Hospital Universitari Vall d'Hebron)
Ntaios, George (University of Thessaly (Grecia))
Foerch, Christian (Goethe University Frankfurt)
Luft, Andreas (University Hospital Zurich (Suïssa))
Spanaus, Katharina (University Hospital Zurich (Suïssa))
Saleh, Lanja (University Hospital Zurich (Suïssa))
von Eckardstein, Arnold (University Hospital Zurich (Suïssa))
Arnold, Markus (University Hospital Zurich (Suïssa))
Katan, Mira (University Hospital Basel (Basilea, Suïssa))
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Early identification of patients developing symptomatic intracranial hemorrhage and symptomatic brain edema after acute ischemic stroke is essential for clinical decision-making. Astroglial protein S-100B is a marker of blood-brain barrier disruption, which plays an important role in the formation of intracranial hemorrhage and brain edema. In this study, we assessed the prognostic value of serum S-100B for the development of these complications. Serum S-100B levels were measured within 24 h from symptom onset in 1749 consecutive acute ischemic stroke patients from the prospective, observational, multicenter BIOSIGNAL cohort study (mean age 72. 0 years, 58. 3% male). To determine symptomatic intracranial hemorrhage or symptomatic brain edema, follow-up neuroimaging was performed in all patients receiving reperfusion therapy or experiencing clinical worsening with an NIHSS increase of ⩾4. Forty six patients (2. 6%) developed symptomatic intracranial hemorrhage and 90 patients (5. 2%) developed symptomatic brain edema. After adjustment for established risk factors, logS-100B levels remained independently associated with both symptomatic intracranial hemorrhage (OR 3. 41, 95% CI 1. 7-6. 9, p = 0. 001) and symptomatic brain edema (OR 4. 08, 95% CI 2. 3-7. 1, p < 0. 001) in multivariable logistic regression models. Adding S-100B to the clinical prediction model increased the AUC from 0. 72 to 0. 75 (p = 0. 001) for symptomatic intracranial hemorrhage and from 0. 78 to 0. 81 (p < 0. 0001) for symptomatic brain edema. Serum S-100B levels measured within 24 h after symptom onset are independently associated with the development of symptomatic intracranial hemorrhage and symptomatic brain edema in acute ischemic stroke patients. Thus, S-100B may be useful for early risk-stratification regarding stroke complications.
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, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Brain edema ; Intracranial hemorrhage ; Ischemic stroke ; S-100B ; Serum biomarker ; Stroke complications
Publicado en:	European Stroke Journal, Vol. 8 (december 2022) , p. 309-319, ISSN 2396-9881

DOI: 10.1177/23969873221145391
PMID: 37021149

11 p, 689.0 KB

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