High Serum Complement Component C4 as An Unique Predictor of Unfavorable Outcomes in Diabetic Stroke

2021 ◽  
Author(s):  
Ximeng Zhang ◽  
Jun Yin ◽  
Kai Shao ◽  
M. Le Yang ◽  
Wei Liu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
High Serum ◽  
Serum Complement ◽  
Complement Protein ◽  
Protein Levels ◽  
Unfavorable Clinical Outcome ◽  
Stroke Group ◽  
Traditional Risk Factors ◽  
Unique Predictor

Abstract Objective: Previous studies demonstrated that diabetic stroke patient had a poor prognosis and excess activation of the complement system in the peripheral blood. In this study, the association of serum complement levels with prognosis of diabetic stroke was examined. Methods: Patients with acute ischemic stroke were recruited and were divided into two groups according to the history of diabetes. Baseline data on the admission including C3 and C4 were collected. Neurologic function at discharge was the primary outcome and was quantified by the National Institutes of Health Stroke Scale (NIHSS). Results: A total of 426 patients with acute ischemic stroke (116 diabetic stroke and 310 non-diabetic stroke) were recruited in this study. There were significant differences on hypertension, CHD, TG, HDL, FGB, C4, and mortality rate between two groups. Furthermore, the values of complement protein levels were divided into tertiles. In diabetic stroke group, serum C4 level at acute phase in the upper third was independently associated with NIHSS score at discharge and concurrent infection. This associations were not significant in non-diabetic stroke. Conclusion: High serum C4 level at admission, as an unique significant predictor, was associated with unfavorable clinical outcome in the diabetic stroke, independently of traditional risk factors.

High serum S-100B protein levels within the first 36 hours of acute ischemic stroke predicts high NIHSS scores

2020 ◽  
Vol 27 (6) ◽  
pp. 1675
Author(s):  
Tugba Hazar ◽  
Bijen Nazliel ◽  
Asli Gurses ◽  
Hale Caglayan ◽  
Ceyla Irkec
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
High Serum ◽  
Protein Levels

Role of S100β Glial Protein as a Serological Marker for Analysis of Acute Ischemic Stroke

2021 ◽  
pp. 251660852110112
Author(s):  
Kiran Buddharaju ◽  
Mahendra Javali ◽  
Anish Mehta ◽  
R Srinivasa ◽  
Purushottam Acharya
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Recovery ◽  
Protein Level ◽  
Serological Marker ◽  
Protein Levels ◽  
S100β Protein ◽  
Asymptomatic Volunteers ◽  
Scale Scores

Background: Stroke is a major cause of neurological disability, which can be often predicted with serological markers. Glial-derived S100β protein is a potential biomarker for cerebral ischemia and may be helpful in predicting the severity, outcome, and recovery of stroke. Aim: This study aimed to study the role of S100β glial protein as a serological marker in predicting the severity of acute ischemic stroke (AIS), outcome, and functional recovery after 1 month. Methods: A hospital-based prospective case control study included 43 consecutive patients, >18 years old, who were admitted with acute middle cerebral artery (MCA) territory infarcts within 72 h of onset of neurological deficits. Control group comprised of 43 age-matched asymptomatic volunteers. Independent t-test and chi square test were used to compare the means and evaluate the association between protein level and various parameters. P ≤ .05 was statistically significant. Results: S100β protein level in AIS patients was significantly higher compared to controls ( P < .05). Elevated serum S100β protein level was found to be associated with larger infarct volumes, higher National Institute Health Stroke Scale scores, and higher modified Rankin Scale scores at admission ( P < .05). Patients with higher S100β protein levels at admission had poor recovery at 1 month compared to patients having normal S100β protein levels. Conclusion: S100β protein levels at admission after an acute MCA territory infarct may be used as a reliable serological tool in predicting the severity, outcome, and functional recovery in stroke.

scholarly journals Clinical Impact of Estradiol/Testosterone Ratio in Patients with Acute Ischemic Stroke

2020 ◽  
Author(s):  
Jung-Won Choi ◽  
In Woo Ryoo ◽  
Jun Yeong Hong ◽  
Kyung-Yul Lee ◽  
Hyo Suk Nam ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Sex Hormones ◽  
Control Group ◽  
Control Groups ◽  
Sexual Hormones ◽  
Stroke Group ◽  
Male Patients ◽  
And Control

Abstract Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS).Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.

Abstract TP75: Normal Appearing White Matter Integrity and Motor Impairment Severity in Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Carson Ingo ◽  
Chen Lin ◽  
James Higgins ◽  
Yurany Arevalo ◽  
Shyam Prabhakaran
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Motor Function ◽  
Motor Impairment ◽  
Internal Capsule ◽  
Posterior Limb ◽  
Normal Appearing White Matter ◽  
Stroke Group ◽  
Microstructural Integrity

Introduction: The effect of white matter hyperintensities (WMH) as measured by fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging on functional impairment and recovery after ischemic stroke has been investigated thoroughly. However, there has been growing interest to investigate normal-appearing white matter (NAWM) microstructural integrity following ischemic stroke onset with techniques such as diffusion tensor imaging (DTI). Methods: 52 patients with acute ischemic stroke and 36 without stroke were evaluated with a DTI and FLAIR imaging protocol and clinically assessed for severity of motor impairment using the Motricity Index within 72 hours of suspected symptom onset. Results: There were widespread decreases in fractional anisotropy (FA) and increases in mean diffusivity (MD) and radial diffusivity (RD) for the acute stroke group compared to the non-stroke group. As shown in the abstract figure with the blue voxels, there was a significant positive association between FA and motor function and a significant negative association between MD/RD and motor function. The NAWM regions of interest that were most sensitive to the Motricity Index were the anterior/posterior limb of the internal capsule in the infarcted hemisphere and the splenium of the corpus callosum, external capsule, posterior limb/retrolenticular part of the internal capsule, superior longitudinal fasciculus, and cingulum (hippocampus) of the intra-/contralateral hemisphere. Conclusion: The microstructural integrity of NAWM is a significant parameter to identify neural differences not only between those individuals with and without acute ischemic stroke, but also correlated with severity of acute motor impairment.

Outcomes between in-hospital stroke and community-onset stroke after thrombectomy: Propensity-score matching analysis

2021 ◽  
pp. 159101992110307
Author(s):  
Kai Qiu ◽  
Qing-Quan Zu ◽  
Lin-Bo Zhao ◽  
Sheng Liu ◽  
Hai-Bin Shi
Keyword(s):  
Ischemic Stroke ◽  
Propensity Score ◽  
Acute Ischemic Stroke ◽  
Propensity Score Matching ◽  
Symptom Onset ◽  
Endovascular Thrombectomy ◽  
Number Of Patients ◽  
Significant Difference ◽  
Stroke Group ◽  
Community Onset

Background The benefit of endovascular thrombectomy for patients with in-hospital stroke remains unclear. Thus, the aim of this study was to compare the endovascular thrombectomy outcomes between in-hospital stroke and community-onset stroke among patients with acute ischemic stroke. Methods From January 2015 to July 2019, 362 consecutive patients with acute ischemic stroke with large vessel occlusion in the anterior circulation received endovascular thrombectomy in our centre. After propensity score matching with a ratio of 1:2 (in-hospital stroke:community-onset stroke), clinical characteristics and functional outcomes were compared between in-hospital stroke and community-onset stroke groups. Results Thirty-six patients with in-hospital stroke and 72 patients with community-onset stroke were enrolled. The number of patients with New York Heart Association classification III/IV (41.7% vs. 6.9%, p < 0.001) and with underlying cancer (25.0% vs. 2.8%, p < 0.001) was higher in the in-hospital stroke than in the community-onset stroke group. The intravenous thrombolysis rate was lower in the in-hospital stroke group (13.9% vs. 43.1%, p = 0.002). No significant difference in symptom onset to puncture ( p = 0.618), symptom onset to recanalisation ( p = 0.618) or good reperfusion (modified thrombolysis in cerebral infarction ≥2 b) rates ( p = 0.852) was found between the groups. The favourable clinical outcome trend (modified Rankin scale ≤2 at 90 days) was inferior, but acceptable, in the in-hospital stroke, group compared to the community-onset stroke group (30.6% vs. 41.7%, p = 0.262). Conclusion Patients with in-hospital stroke had more disadvantageous comorbidities than those with community-onset stroke. Cardiac dysfunction seems to be associated with poor outcomes after thrombectomy. Nevertheless, endovascular thrombectomy still appears to be safe and effective for patients with in-hospital stroke.

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