Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU

Introduction. Brain ischemia initiated significant increase in FFAs in animal studies. Accumulation of FFA can lead to liberation of inflammatory byproducts that contribute to neuronal death. Increased risk of systemic thromboembolism was seen in animal models after FFA infusion possibly through activation of factor XII by stearic acids. The clinical studies that examined the relation between stroke in humans and CSF biomarkers are infrequent. Aim of Work. We tried to evaluate the potential role of FFAs in CSF in the diagnosis and the prognosis of ICU patients with AIS while comparing the results to traditional neurological scoring systems. Patients and Methods. Our study included 80 patients who were admitted to ICU with acute ischemic stroke (AIS) within 24 hours of the onset of cerebral infarction. CSF samples were obtained at admission. The FFA levels were measured using the sensitive enzyme-based colorimetric method. The NIHSS, GCS, and mRS were evaluated at admission and at 30 days. Univariate and multivariate analysis were used to evaluate the stroke outcome according to FFA levels in CSF. Results. Worsening of the GCS (<7) at 30 days showed a significant correlation with FFA in CSF. The ROC curve showed a cutoff value of 0.27 nmol/µl, sensitivity of 62.9%, and specificity of 72.2%. There was a significant correlation between FFA in CSF and the mRS >2 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/µl, specificity of 69.2%, and sensitivity of 59.7%. There was a significant correlation between FFA in CSF and the NIHSS ≥ 16 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/µl, specificity of 72.2%, and sensitivity of 62.9%. Our study subdivided patients according to infarction volume and compared the 2 subgroups with FFA in CSF. We found a significant difference between 2 subgroups. FFA levels showed a positive correlation with infarction volume ≥145 ml. The ROC curve showed a cutoff value of 0.25 nmol/µl, sensitivity of 76.9%, and specificity of 71.4%. Our study showed that FFA in CSF was a significant predictor of all-cause mortality (0.37 + 0.26, P value 0.007). The ROC curve showed a cutoff value of 0.27, specificity of 72.2%, and sensitivity of 62.9%. There was a positive correlation between FFA in CSF and neurological causes of mortality (0.48 + 0.38, P value 0.037). The ROC curve showed a cutoff value of 0.37 nmol/µl, specificity of 76.1%, and sensitivity of 61.5%. Conclusion. FFA in CSF may serve as an independent prognostic biomarker for assessing the prognosis of acute ischemic stroke and the clinical outcome. It might be a useful biomarker for early detection of high-risk patients for poor outcome and hence more aggressive treatment.

Download Full-text

2D Parametric Parenchymal Blood Flow as a Predictor of the Hemorrhagic Events after Endovascular Treatment of Acute Ischemic Stroke: A Single-Center Retrospective Study

Interventional Neurology ◽

10.1159/000491762 ◽

2018 ◽

Vol 7 (6) ◽

pp. 522-532 ◽

Cited By ~ 4

Author(s):

Nada Elsaid ◽

Ahmed Saied ◽

Krishna Joshi ◽

Jessica Nelson ◽

John Baumgart ◽

...

Keyword(s):

Blood Flow ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Dual Energy Ct ◽

Anterior Circulation ◽

Brain Scans ◽

Increased Risk ◽

Significant Difference ◽

Hemorrhagic Events ◽

Ct Brain

Background and Purpose: Intracranial hemorrhage (ICH) is one of the major adverse events related to the endovascular management of acute ischemic stroke. It is important to evaluate the risk of ICH as it may result in clinical deterioration of the patients. Development of tools which can predict the risk of ICH after thrombectomy can reduce the procedure-related morbidity and mortality. 2D parenchymal blood flow could potentially act as an indicator for ICH. Methods: 2D parenchymal blood flow was used to evaluate pre- and postthrombectomy digital subtraction angiography series of patients with acute ischemic stroke in the anterior circulation. A recently developed software allows the separation of the vascular filling and parenchymal blush signals using band-pass and band-reject filtering to allow for greater visibility of the parenchyma offering a better visual indicator of the effect of treatment. The “wash-in rate” was selected as the parameter of interest to predict ICH. Results: According to the presence or absence of signs of intracranial parenchymal hemorrhage in the follow-up dual-energy CT brain scans, the patients were classified into a hemorrhagic and nonhemorrhagic group (15 patients each). The only significant difference between the groups is the calculated wash-in rate after thrombectomy (p = 0.024). The cutoff value of the wash-in rate after thrombectomy was suggested to be 11,925.0, with 60% sensitivity to predict the hemorrhage and 93.3% specificity. Conclusions: Elevated parametric parenchymal blood flow wash-in rates after thrombectomy may be associated with increased risk of hemorrhagic events.

Download Full-text

Abstract P12: Alteplase Reduces Mortality in Patients With Ischemic Stroke and Atrial Fibrillation: Analysis of the IAC Study

Stroke ◽

10.1161/str.52.suppl_1.p12 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Shadi Yaghi ◽

Eva Mistry ◽

Adam H De Havenon ◽

Christopher Leon Guerrero ◽

Amre Nouh ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Infarct Volume ◽

Intravenous Thrombolysis ◽

The United States ◽

Hemorrhagic Transformation ◽

Stroke Patients ◽

Increased Risk ◽

Significant Difference

Background and Purpose: Multiple studies have established that intravenous thrombolysis with alteplase improves outcome after acute ischemic stroke. However, assessment of thrombolysis’ efficacy in stroke patients with atrial fibrillation (AF) has yielded mixed results. We sought to determine the association of alteplase with mortality, hemorrhagic transformation (HT), infarct volume, and mortality in patients with AF and acute ischemic stroke. Methods: We retrospectively analyzed consecutive acute ischemic stroke patients with AF included in the Initiation of Anticoagulation after Cardioembolic stroke (IAC) study, which pooled data from 8 comprehensive stroke centers in the United States. 1889 (90.6%) had available 90-day follow up data and were included. For our primary analysis we used a cohort of 1367/1889 (72.4%) patients who did not undergo mechanical thrombectomy (MT). Secondary analyses were repeated in the patients that underwent MT (n=522). Binary logistic regression was used to determine whether alteplase use was independently associated with risk of HT, final infarct volume, and 90-day mortality, respectively, adjusting for potential confounders. Results: In our primary analyses we found that alteplase use was independently associated with an increased risk for HT (adjusted OR 2.14, 95% CI 1.49 - 3.07, p <0.001) but overall reduced risk of 90-day mortality (adjusted OR 0.58, 95% CI 0.39 - 0.87, p = 0.009). Among patients undergoing MT, alteplase use was associated with a trend towards a reduction in 90-day mortality (adjusted OR 0.68 95% CI 0.45 - 1.04, p = 0.077). In the subgroup of patients prescribed DOAC treatment (n = 327; 24 received alteplase), alteplase treatment was associated with a trend towards smaller infarct size (< 10 mL), (adjusted OR 0.40, 95% CI 0.15 - 1.12, p = 0.082) without a significant difference in the odds of 90-day mortality (adjusted OR 0.51, 95% CI 0.12 - 2.13, p = 0.357) or hemorrhagic transformation (adjusted OR 0.27, 95% CI 0.03 - 2.07, p = 0.206). Conclusion: Thrombolysis with intravenous alteplase was associated with reduced 90-day mortality in AF patients with acute ischemic stroke not undergoing MT. Further study is required to assess the safety and efficacy of alteplase in AF patients undergoing MT and those on DOACs.

Download Full-text

Abstract 202: The NIH Stroke Scale Can Miss Improvement After IV tPA For Acute Ischemic Stroke

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.8.suppl_2.202 ◽

2015 ◽

Vol 8 (suppl_2) ◽

Author(s):

Elisabeth B Marsh ◽

Erin Lawrence ◽

Rafael H Llinas

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Post Treatment ◽

Functional Improvement ◽

Stroke Severity ◽

Post Discharge ◽

Significant Difference ◽

The Mean ◽

Iv Tpa

Background and Objective: The National Institute of Health Stroke Scale (NIHSS) is the most commonly used metric to evaluate stroke severity and improvement following intervention. Despite its advantages as a rapid, reproducible screening tool, it may be too insensitive to adequately capture functional improvement following treatment. We evaluated the difference in rate of improvement by previously accepted criteria (change of ≥4 NIHSS points) versus physician documentation in patients receiving IV tissue plasminogen activator (tPA) for acute ischemic stroke. Methods: Prospectively collected data on all patients receiving IV tPA over a 15 month period were retrospectively reviewed. NIHSS 24 hours post-treatment and on discharge were extrapolated based on examination and compared to NIHSS on presentation. NIHSS scores at post-discharge follow-up were also recorded. Two reviewers evaluated the medical record and determined improvement based on physician documentation. Using tests of proportion, ‘significant improvement’ by NIHSS was compared to physician documentation at each time point. Results: Forty-one patients were treated with IV tPA. The mean admission NIHSS was 8.6 and improved to 6.4 24 hours post-tPA. Twenty-nine of 41 patients (79%) were “better” by documentation; however only 11/41 (27%) met NIHSS criteria for improvement (p compared to documentation <0.001). On discharge, 20/41 patients (49%) met NIHSS criteria for improvement; however a significant difference between physician documentation remained (p=0.04). The mean post-discharge follow-up NIHSS score was 2.0. 20/21 patients (95%) were “better” compared to 16/21 (76%) meeting NIHSS criteria (p=0.08). Conclusion: The NIHSS may inadequately capture functional improvement post-treatment, especially in the days immediately following intervention.

Download Full-text

Acute Ischemic Stroke in Patients With COVID-19

Stroke ◽

10.1161/strokeaha.121.034301 ◽

2021 ◽

Vol 52 (5) ◽

pp. 1826-1829

Author(s):

Pratyaksh K. Srivastava ◽

Shuaiqi Zhang ◽

Ying Xian ◽

Hanzhang Xu ◽

Christine Rutan ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Odds Ratio ◽

Adverse Outcomes ◽

National Institutes Of Health ◽

Stroke Severity ◽

Younger Age ◽

Increased Risk ◽

Scale Scores ◽

Get With The Guidelines

Background and Purpose: Studies suggest an increased risk of adverse outcomes among patients with acute ischemic stroke (AIS) and coronavirus disease 2019 (COVID-19). Methods: Using Get With The Guidelines–Stroke, we identified 41 971 patients (AIS/COVID-19: 1143; AIS/no COVID-19: 40 828) with AIS hospitalized between February 4, 2020 and June 29, 2020, from 458 Get With The Guidelines–Stroke hospitals with at least one COVID-19 case and evaluated clinical characteristics, treatment patterns, and outcomes. Results: Compared with patients with AIS/no COVID-19, those with AIS/COVID-19 were younger, more likely to be non-Hispanic Black, Hispanic, or Asian, more likely to present with higher National Institutes of Health Stroke Scale scores, and had greater proportions of large vessel occlusions. Rates of thrombolysis and thrombectomy were similar between the groups. Door to computed tomography (median 55 [18–207] versus 35 [14–99] minutes, P <0.001), door to needle (59 [40–82] versus 46 [33–64] minutes, P <0.001), and door to endovascular therapy (114 [74–169] versus 90 [54–133] minutes, P =0.002) times were longer in the AIS/COVID-19 cohort. In adjusted models, patients with AIS/COVID-19 had decreased odds of discharge with modified Rankin Scale score of ≤2 (odds ratio, 0.65 [95% CI, 0.52–0.81], P <0.001) and increased odds of in-hospital mortality (odds ratio, 4.34 [95% CI, 3.48–5.40], P <0.001). ConclusionS: This analysis demonstrates younger age, greater stroke severity, longer times to evaluation and treatment, and worse morbidity and mortality in patients with AIS/COVID-19 compared with those with AIS/no COVID-19.

Download Full-text

New Thrombotic Events in Ischemic Stroke Patients with Elevated Factor VIII

Thrombosis ◽

10.1155/2014/302861 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Brittany M. Gouse ◽

Amelia K. Boehme ◽

Dominique J. Monlezun ◽

James E. Siegler ◽

Alex J. George ◽

...

Keyword(s):

Ischemic Stroke ◽

Venous Thrombosis ◽

Factor Viii ◽

Acute Ischemic Stroke ◽

Stroke Severity ◽

Stroke Patients ◽

Stroke Registry ◽

Increased Risk ◽

Baseline Characteristics

Background. Heightened levels of Factor VIII (FVIII) have been associated with both arterial and venous thrombosis. While elevated FVIII is common during acute ischemic stroke (AIS), whether elevated FVIII confers an increased risk for recurrent thrombotic events (RTEs) following AIS has not been previously explored. Methods. Consecutive AIS patients who presented to our center between July 2008 and September 2013 and had FVIII measured during admission were identified from our stroke registry. Baseline characteristics and the occurrence of RTE (recurrent or progressive ischemic stroke, DVT/PE, and MI) were compared in patients with and without elevated FVIII levels. Results. Of the 298 patients included, 203 (68.1%) had elevated FVIII levels. Patients with elevated FVIII had higher rates of any in-hospital RTE (18.7% versus 8.4%, P=0.0218). This association remained after adjustment for baseline stroke severity and etiology (OR 1.01, 95% CI 1.00–1.01, P=0.0013). Rates of major disability were also higher in patients who experienced a RTE (17.8% versus 3.2%, P<0.0001). Conclusion. A significantly higher frequency of in-hospital RTEs occurred in AIS patients with elevated FVIII. The occurrence of such events was associated with higher morbidity. Further study is indicated to evaluate whether FVIII is a candidate biomarker for increased risk of RTEs following AIS.

Download Full-text

Abstract T P24: Neurointervention for Acute Ischemic Stroke Caused by Carotid Dissection

Stroke ◽

10.1161/str.46.suppl_1.tp24 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Diogo C Haussen ◽

Andrey Lima ◽

Mikayel Gregoryan ◽

Jonathan Grossberg ◽

Leah Craft ◽

...

Keyword(s):

Ischemic Stroke ◽

Carotid Artery ◽

Acute Ischemic Stroke ◽

Endovascular Therapy ◽

Hemorrhagic Transformation ◽

Carotid Artery Dissection ◽

Artery Dissection ◽

Stroke Severity ◽

Carotid Dissection ◽

Increased Risk

Introduction: Data related to the treatment of patients with acute ischemic stroke caused by carotid artery dissection is scarce. Methods: We retrospectively reviewed our interventional stroke database Sep 2010 - Jan 2014 to investigate the clinical and radiological characteristics of patients presenting with tandem cervical and intracranial occlusions due to cervical carotid dissection. Results: Out of 504 consecutive patients treated with endovascular therapy for acute ischemic stroke during the study period, 12 (2.5%) patients were observed to have cervical carotid artery dissection as the underlying etiology. Mean age was 56±13 years, 75% were male, 50% received IV t-PA, mean NIHSS was 20±5, 75% had CT ASPECTS≥7, and mean time from last known normal to groin puncture was 6±3 hours. There were 4 MCA M1, 1 MCA M2 and 7 ICA-T occlusions. Extracranial carotid stent was used in 58% and angioplasty in 8% of cases. In 33% of the cases, the carotid dissection was not stented due to the fear of hemorrhagic transformation in cases of IV thrombolysis (presumably increased risk if dual antithrombotics used). IA tPA was used in 41% of cases, while Merci in 16%, Penumbra in 58%, and stentretrivers in 50%. Intracranial TICI 2b-3 reperfusion was achieved in 91% of patients, with PH2 hemorrhage in 8% and mRS at 90 days in 45% of cases. Conclusions: Carotid dissections with associated intracranial occlusions are often refractory to IV tPA and present with a high stroke severity. These lesions are amenable to endovascular therapy resulting in high rates of reperfusion with an acceptable safety profile.

Download Full-text

Abstract 2783: Disparities in Ischemic Stroke Presentation and Outcomes Based on Human Development Index of a Nation: A Secondary Analysis of International Stroke Trial

Stroke ◽

10.1161/str.43.suppl_1.a2783 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Yogesh Moradiya ◽

Sneha Modi

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Human Development ◽

Human Development Index ◽

Functional Dependence ◽

National Development ◽

Stroke Severity ◽

Development Index ◽

Significant Difference ◽

Stroke Trial

Background and Purpose: Human Development Index (HDI), a comparative composite measure of health, education and standard of living of nations worldwide, is published annually by United Nations Development Programme (UNDP). Our aim was to study the disparities in presentation and outcomes of acute ischemic stroke based on HDIs of nations. Methods: We used the International Stroke Trial (IST) database which was recently made available for public use for novel secondary analyses by independent researchers. IST, one of the largest prospective randomized controlled trials of acute stroke, was conducted in 467 hospitals of 36 countries in years 1991-1996 and included 19435 patients to study the effect of early treatment with aspirin and heparin in acute ischemic stroke. The trial had 99% complete six month follow-up data. We used the internet tool available on UNDP website to find HDIs of participating nations for the year 1995. We calculated National Institute of Health Stroke Scale equivalent stroke severity scale from the clinical findings present on admission. We only included the cases with final diagnosis of acute ischemic stroke and with known HDI (n=17262) in our analysis. We used χ 2 and one-way ANOVA to compare demographic and clinical characteristics between HDI groups. Multivariate logistic regression was used to study numeric HDI value multiplied by 100 as an independent predictor of various outcomes in stroke. Results: There was a significant difference in all the studied stroke characteristics between different HDI groups ( Table 1 ). With each unit increment in HDI by 0.01, odds of in-hospital mortality, complete functional recovery at six months and all-cause mortality at six months decreased by 2.3%, 3.6% and 2.8% respectively and odds of in-hospital recurrent ischemic stroke and functional dependence at six months increased by 4.8% and 2.7% respectively. HDI value could not predict intracranial hemorrhage or major non-cerebral bleeding significantly ( Table 2 ). Conclusions: We identified significant disparities in ischemic stroke presentation and outcomes between countries with different levels of national development. The disparities may have important implications in international health policy making and planning of multinational clinical trials involving acute ischemic stroke.

Download Full-text

Abstract P208: Racial Differences in Stroke Severity and Outcomes in Female Acute Ischemic Stroke Patients

Circulation ◽

10.1161/circ.127.suppl_12.ap208 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Amelia K Boehme ◽

James E Siegler ◽

Karen C Albright ◽

Dominique J Monlezun ◽

Erica M Jones ◽

...

Keyword(s):

Ischemic Stroke ◽

Black Women ◽

Acute Ischemic Stroke ◽

Racial Differences ◽

White Women ◽

Lower Percentage ◽

Stroke Severity ◽

Discharge Disposition ◽

Significant Difference ◽

Iv Tpa

Background: Previous research has indicated that women and Blacks have worse outcomes following acute ischemic stroke (AIS). Little research has been done to investigate the influence of race in the presentation and outcome specifically among women with AIS. Methods: AIS patients presenting to two centers in the Stroke Belt (2004-2011) were identified by prospective registries. Men, women who did not identify as Black or White, and in-hospital strokes were excluded. Patient demographics, clinical characteristics, admission National Institutes of Health Stroke Scale (NIHSS) scores, favorable discharge disposition (home or inpatient rehab), time from last seen normal to ED arrival, and functional discharge outcome as measured by the modified Rankin Scale (mRS) were investigated. Patients were divided into 3 groups: (1) not treated with IV t-PA, (2) treated with IV t-PA within 3 hours of symptom onset, and (3) treated with IV t-PA beyond 3 hours. Results: Of the 8763 patients screened, 2217 women met the study criteria (59% White). White women were older (72 vs. 64; p<0.0001), had higher percentage of atrial fibrillation (24% vs. 11%; p<0.0001), lower percentage of diabetes (30% vs. 40%, p<0.0001), lower percentage of hypertension (73% vs. 84%; p<0.0001) and had a higher baseline NIHSS (9 vs. 7; p=0.0045) Administration of tPA was significantly less among Black women (36% Whites vs. 27% Blacks, p<0.0001). White women are at increased odds of receiving tPA treatment (OR=1.43, 95%CI 1.17-1.75, p=0.0005), and remain at increased odds after adjusting for age, baseline NIHSS, time from last seen normal and glucose (OR 1.42, 95% CI 1.11-1.81, p=00044). Despite the significant difference in treatment with IV tPA, White women had increased odds of having a poor functional outcome (OR=1.2, 95% CI 1.02-1.439,p=0.0250) and unfavorable discharge disposition (OR 1.4, 95% CI 1.18-1.67, p=0.0001), but stratifying by tPA treatment groups, race was not found to be predictive of outcome after adjusting for known confounders (i.e., age, glucose, baseline NIHSS, time from last seen normal). Discussion: Unlike data from previous studies, Black women who presented to these two centers with AIS had less severe neurologic deficits on presentation compared to their White counterparts. Despite differences in the proportion of Blacks and Whites treated with IV tPA, race was not significantly associated with outcome. In our study, age and stroke severity_not race_were the primary predictors for poor outcome.

Download Full-text

Mechanical thrombectomy for acute ischemic stroke with occlusion of the M2 segment of the middle cerebral artery: a meta-analysis

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2017-013515 ◽

2017 ◽

Vol 10 (7) ◽

pp. 620-624 ◽

Cited By ~ 55

Author(s):

Hamidreza Saber ◽

Sandra Narayanan ◽

Mohan Palla ◽

Jeffrey L Saver ◽

Raul G Nogueira ◽

...

Keyword(s):

Ischemic Stroke ◽

Middle Cerebral Artery ◽

Acute Ischemic Stroke ◽

Cerebral Artery ◽

Mechanical Thrombectomy ◽

Meta Analysis ◽

Functional Independence ◽

Vessel Occlusion ◽

Increased Risk ◽

Significant Difference

BackgroundEndovascular thrombectomy has demonstrated benefit for patients with acute ischemic stroke from proximal large vessel occlusion. However, limited evidence is available from recent randomized trials on the role of thrombectomy for M2 segment occlusions of the middle cerebral artery (MCA).MethodsWe conducted a systematic review and meta-analysis to investigate clinical and radiographic outcomes, rates of hemorrhagic complications, and mortality after M2 occlusion thrombectomy using modern devices, and compared these outcomes against patients with M1 occlusions. Recanalization was defined as Thrombolysis in Cerebral Infarction (TICI) 2b/3 or modified TICI 2b/3.ResultsA total of 12 studies with 1080 patients with M2 thrombectomy were included in our analysis. Functional independence (modified Rankin Scale 0–2) rate was 59% (95% CI 54% to 64%). Mortality and symptomatic intracranial hemorrhage rates were 16% (95% CI 11% to 23%) and 10% (95% CI 6% to 16%), respectively. Recanalization rates were 81% (95% CI 79% to 84%), and were equally comparable for stent-retriever versus aspiration (OR 1.05; 95% CI 0.91 to 1.21). Successful M2 recanalization was associated with greater rates of favorable outcome (OR 4.22; 95% CI 1.96 to 9.1) compared with poor M2 recanalization (TICI 0–2a). There was no significant difference in recanalization rates for M2 versus M1 thrombectomy (OR 1.05; 95% CI 0.77 to 1.42).ConclusionsThis meta-analysis suggests that mechanical thrombectomy for M2 occlusions that can be safely accessed is associated with high functional independence and recanalization rates, but may be associated with an increased risk of hemorrhage.

Download Full-text

Blood Pressure and Heat Shock Protein 70 Levels Related to Acute Ischemic Stroke Severity

Green Medical Journal ◽

10.33096/gmj.v2i2.55 ◽

2020 ◽

Vol 2 (2) ◽

pp. 49-55

Author(s):

Syarif Indra ◽

Umul Khair ◽

Yulia Trisna

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Heat Shock ◽

Heat Shock Protein ◽

Acute Ischemic Stroke ◽

P Value ◽

Stroke Severity ◽

Hsp 70 ◽

Cross Sectional ◽

Significant Difference

Introduction: Hypertension is a risk factor of ischemic stroke, the prevalence of ischemic stroke in Indonesia is 34.1%. Heat Shock Protein (HSP) 70 increases in hypertension and acute phase of ischemic stroke. To determine differences of blood pressure (BP) and HSP 70 levels, related to the acute ischemic stroke severity. Methods: This was a cross-sectional study that was carried out in the Neurological Ward of Dr.M.Djamil Hospital and National Stroke Hospital, from May to September 2019. Inclusion criteria were obtained consecutively. BP was measured with a sphygmomanometer, stroke severity was measured by NIHSS, and HSP 70 levels was analyzed by the ELISA. Computerized statistical analyzes were performed using SPSS software version 23.0 for windows. The result was statistically significant if the p-value < 0.05. Results: There were 40 samples consisted of 26 (65%) male, mean age 59.78 years. The systolic BP ranging from 130 to 190 mmHg (median 160), the diastolic BP ranging from 70 to 100 mmHg (median 90), the HSP 70 levels ranging from 2.50 to 19.56 ng/mL (median 2.72). There were 18 patients with mild stroke and 22 patients with moderate stroke. There was no significant difference between systolic blood pressure (SBP), diastolic blood pressure (DBP), and severity of stroke (p=0,369; p=0,221, respectively). There was no significant difference between HSP 70 levels and the severity of stroke (p=0,312). There was no relation between the degree of BP and HSP 70 levels. Conclusion: There were no significant differences of SBP, DBP, and HSP 70 with the acute ischemic stroke severity.

Download Full-text