scholarly journals 029 High Sensitivity Troponin in Acute Ischaemic Stroke Study (TACIS)

2021 ◽  
Author(s):  
Andrew Hannaford ◽  
Michael Hayes ◽  
John Worthington ◽  
Timothy Ang ◽  
Nimalin Harinesan
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
High Sensitivity ◽  
High Sensitivity Troponin ◽  
Stroke Study

scholarly journals High-Sensitivity Troponin Elevation in Ischaemic Stroke and Associated Cardiac Abnormalities

2017 ◽  
Vol 26 ◽  
pp. S57
Author(s):  
A. Koshy ◽  
J. Sajeev ◽  
N. Cosgrave ◽  
M. Tan ◽  
K. Rajakariar ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
High Sensitivity ◽  
Troponin Elevation ◽  
Cardiac Abnormalities ◽  
High Sensitivity Troponin

scholarly journals Brain imaging abnormalities and outcome after acute ischaemic stroke: the ENCHANTED trial

2020 ◽  
Vol 91 (12) ◽  
pp. 1290-1296 ◽  
Author(s):  
Candice Delcourt ◽  
Xia Wang ◽  
Zien Zhou ◽  
Joanna M Wardlaw ◽  
Grant Mair ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Brain Imaging ◽  
Acute Ischaemic Stroke ◽  
Imaging Features ◽  
Acute Ischaemia ◽  
Logistic Regression Models ◽  
Stroke Study ◽  
Scale Scores ◽  
Ischaemic Lesion ◽  
Imaging Signs

ObjectiveTo test the hypothesis that imaging signs of ‘brain frailty’ and acute ischaemia predict clinical outcomes and symptomatic intracranial haemorrhage (sICH) after thrombolysis for acute ischaemic stroke (AIS) in the alteplase dose arm of ENhanced Control of Hypertension ANd Thrombolysis strokE stuDy (ENCHANTED).MethodsBlinded assessors coded baseline images for acute ischaemic signs (presence, extent, swelling and attenuation of acute lesions; and hyperattenuated arteries) and pre-existing changes (atrophy, leucoaraiosis and old ischaemic lesions). Logistic regression models assessed associations between imaging features and death at 7 and 90 days; good recovery (modified Rankin Scale scores 0–2 at 90 days) and sICH. Data are reported with adjusted ORs and 95% CIs.Results2916 patients (67±13 years, National Institutes of Health Stroke Scale 8 (5–14)) were included. Visible ischaemic lesions, severe hypoattenuation, large ischaemic lesion, swelling and hyperattenuated arteries were associated with 7-day death (OR (95% CI): 1.52 (1.06 to 2.18); 1.51 (1.01 to 2.18); 2.67 (1.52 to 4.71); 1.49 (1.03 to 2.14) and 2.17 (1.48 to 3.18)) and inversely with good outcome. Severe atrophy was inversely associated with 7-day death (0.52 (0.29 to 0.96)). Atrophy (1.52 (1.08 to 2.15)) and severe leucoaraiosis (1.74 (1.20 to 2.54)) were associated with 90-day death. Hyperattenuated arteries were associated with sICH (1.71 (1.01 to 2.89)). No imaging features modified the effect of alteplase dose.ConclusionsNon-expert-defined brain imaging signs of brain frailty and acute ischaemia contribute to the prognosis of thrombolysis-treated AIS patients for sICH and mortality. However, these imaging features showed no interaction with alteplase dose.

scholarly journals The Clinical Significance of Fibrin Monomers

2018 ◽  
Vol 118 (11) ◽  
pp. 1856-1866 ◽  
Author(s):  
Majed Refaai ◽  
Paul Riley ◽  
Tatsiana Mardovina ◽  
Phoenix Bell
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
High Sensitivity ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Test Probability ◽  
Definitive Role

Introduction Fibrin monomer (FM) concentrations reflect pro-thrombin activity and have the potential to predict thrombotic events relatively earlier than other haemostatic markers. Most often, FM are compared with D-dimer (DD) as increased DD have been documented in disseminated intravascular coagulation (DIC), deep vein thrombosis (DVT) and pulmonary embolism. Although DD have a high sensitivity and negative predictive value, their specificity is much lower depending on the assay chosen, clinical pre-test probability and patient condition. There are limited reports investigating the utility of FM in hyper-coagulable patients. Methods We performed a literature search of FM concentrations in hyper-coagulable patients including those with DIC, acute ischaemic stroke, atrial fibrillation, acute myocardial infarction, venous thromboembolism (VTE) and cancer, as well as those who are pregnant or undergoing surgery. Results FM were increased in patients with DIC and those with malignancy. In contrast, detection of VTE or post-operative DVT development is likely enhanced using both FM and DD concentrations. Similarly, measuring FM concentrations with other biomarker levels may be more beneficial in patients suffering an acute myocardial infarction or acute ischaemic stroke. Lastly, FM concentrations vary substantially throughout pregnancy with no definitive role of FM as of yet. Conclusion Utilizing FM concentrations to assess hyper-coagulable patients seems promising; however, there are limitations including variations in FM cut-off values, the effect of patient medications and the timing of FM measurement relative to an acute event. Thus, further investigation is required before a true advantage for FM as a haemostatic marker can be established.

New biomarker for acute ischaemic stroke: plasma glycogen phosphorylase isoenzyme BB

2017 ◽  
Vol 89 (4) ◽  
pp. 404-409 ◽  
Author(s):  
Kwang-Yeol Park ◽  
Ilknur Ay ◽  
Ross Avery ◽  
Juan Alfredo Caceres ◽  
Matthew S Siket ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Roc Curve ◽  
Glycogen Phosphorylase ◽  
Infarct Volume ◽  
High Sensitivity ◽  
Acute Ischaemia ◽  
Acute Infarct ◽  
Key Enzyme ◽  
The Mean

BackgroundGlycogen phosphorylase is the key enzyme that breaks down glycogen to yield glucose-1-phosphate in order to restore depleted energy stores during cerebral ischaemia. We sought to determine whether plasma levels of glycogen phosphorylase BB (GPBB) isoform increased in patients with acute ischaemic stroke (AIS).MethodsWe studied plasma GPBB levels within 12 hours and again at 48±24 hours of symptom onset in 172 patients with imaging-confirmed AIS and 133 stroke-free individuals. We determined the ability of plasma GPBB to discriminate between cases and controls and examined the predictive value of plasma GPBB for 90-day functional outcome, 90-day survival and acute lesion volumes on neuroimaging.ResultsThe mean (SD) GPBB levels were higher in cases (46.3±38.6 ng/mL at first measurement and 38.6±36.5 ng/mL at second measurement) than in controls (4.1±7.6 ng/mL, p<0.01 for both). The area under the receiver operating characteristic (ROC) curve for case–control discrimination based on first GPBB measurement was 0.96 (95% CI 0.93 to 0.98). The sensitivity and specificity based on optimal operating point on the ROC curve (7.0 ng/mL) were both 93%. GPBB levels increased in 90% of patients with punctate infarcts (<1.5 mL) and in all patients admitted within the first 4.5 hours of onset. There was no correlation between GPBB concentration and either clinical outcome or acute infarct volume.ConclusionGPBB demonstrates robust response to acute ischaemia and high sensitivity for small infarcts. If confirmed in more diverse populations that also include stroke mimics, GPBB could find utility as a stand-alone marker for acute brain ischaemia.

scholarly journals Basal IL-6 and S100b levels predict infarct volume in acute ischaemic stroke patients

2020 ◽  
Author(s):  
Francisco Purroy ◽  
Joan Farre-Rodriguez ◽  
Gerard Mauri-Capdevila ◽  
Mikel Vicente-Pascual ◽  
Joan Farre
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Small Vessel Disease ◽  
Infarct Volume ◽  
Neuron Specific Enolase ◽  
High Sensitivity ◽  
Surrogate Endpoint ◽  
Lesion Volume ◽  
Anterior Circulation ◽  
Ischemic Lesion

Abstract Background: The study of biomarkers related to the infarct volume of acute ischaemic stroke (AIS) is a valuable clinical strategy. We conducted a prospective study to evaluate the relationship between a wide panel of biomarkers involved in different biochemical pathways and lesion volume. Methods: We studied 332 patients with AIS. Infarct volume was calculated from diffusion weighted imaging (DWI). Blood samples were drawn within 24 h of symptom onset to test a panel of biomarkers that included high-sensitivity C-reactive protein (hs-CRP), IL-6, neuron-specific enolase (NSE), N-terminal pro-B-type natriuretic peptide (NT-ProBNP), S100b, troponin and IL-10. Results: The median lesion volume was 2.5 cc (IQR: 0.6-15.3). Patients with previous atrial fibrillation, cardioembolic aetiology and total anterior circulation infarct TACI classification had higher lesion volumes than those without them. Patients with previous recent TIA had smaller ischemic lesions than those without it. Age and NIHSS were significantly correlated with lesion volume. In a lineal regression analysis adjusted by aetiology, S100b and IL-6 emerged as the only biomarkers that could independently predict infarct volume. In contrast, previous recent TIA and small vessel disease were inversely related to infarct volume. Conclusion: The correlation between the two blood marker levels and ischemic lesion volume would support the use of these biomarkers as a surrogate endpoint in AIS, especially in centres without DWI 24/7. Our findings should be further explored in larger, preferably multicentre studies.

Sign in / Sign up

Export Citation Format

Share Document