STUDY ON VWF, VCAM-1, MCP-1, D-DIMER BIOMARKER COMPLEX IN THE PROGNOSIS OF ACUTE ISCHEMIC STROKE

2017 ◽  
pp. 64-74
Author(s):  
Long Nhon Phan ◽  
khanh Hoang ◽  
Van Minh Huynh
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
High Sensitivity ◽  
High Specificity ◽  
Descriptive Study ◽  
Average Concentration ◽  
Clinical Severity ◽  
Cross Sectional ◽  
D Dimer

Objective: To survey the level of vWF VCAM-1, MCP-1, D-Dimer and evaluate the clinical severity prognosis of vWF, VCAM-1, MCP-1, D-dimer biomarker complex in acute ischemic stroke. Subjects and methods: A cross-sectional descriptive study, which compares between 50 patients of acute ischemic stroke and 40 healthy controls. Results: 1. The average concentration of vWF, VCAM-1, MCP-1, D-Dimer of acute ischemic stroke and controled groups were: vWF 177.80 ± 6.90MU/ml patient/148.98±19.04MU/ml control; VCAM-1 53.79±3.33ng/ml patient/43.91 ± 4.77 control; MCP-1 357.37 ± 111.03pg/ml patient/190.80 ± 51.6 pg/ml control, and D-Dimer 1016.72 ± 524.06ng/ml patient, 329.40 ± 90.16ng/ml control, p<0.001. 2. The vWF, VCAM-1, MCP-1, D-Dimer biomarker complex had a high value in prediction of clinical severity level and clinical severity progression after 48 hours of symptom onset of acute iskemic stroke. The prognostic value of clinical severity progression after 48 hours was the highest with 81.61% sensitivity, 81.42% specificity, 77.17% positive predictive value, 85.19% negative predictive value, p> 0.001, OR = 19.44. Conclusion: Concentrations of vWF, VCAM-1, MCP-1, D-Dimer increased in patients with acute ischemic stroke. The vWF, VCAM-1, MCP1, D-Dimer biomarker complex had a high value in prognosis with high sensitivity and high specificity.

Association of Iron Deficiency Anemia with Stroke Severity in patients with Acute Ischemic Stroke

2021 ◽  
Vol 15 (11) ◽  
pp. 3004-3006
Author(s):  
Rabia Rathore ◽  
Nasir Farooq Butt ◽  
Adil Iqbal ◽  
Hina Latif ◽  
Mariam Azeem ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Iron Deficiency ◽  
Acute Ischemic Stroke ◽  
Iron Deficiency Anemia ◽  
Descriptive Study ◽  
World Health ◽  
Deficiency Anemia ◽  
P Value ◽  
Stroke Severity ◽  
Cross Sectional

Aim: To study the relationship of Iron Deficiency anemia (IDA) with severity of acute ischemic stroke. Study Design: A cross-sectional descriptive study. Place & Duration of Study: Department of Medicine, Mayo Hospital, Lahore from March 2020 to February 2021 Methods: A descriptive study of cross-sectional type was done on 200 individuals who had acute ischemic stroke (AIS) and were hospitalized at Mayo Hospital Lahore. Consecutive non-probability convenience sampling method was used to gather the data. Severity of stroke was assessed at the time of admission using the National Institute of Health Stroke Scale, (NIHSS) at the same time blood complete examination along with peripheral blood film was done to diagnose anemia in these patients. Iron studies were done to diagnose iron deficiency anemia (IDA). P-value less than 0.05 was taken as significant. Results: About 200individuals presenting with AIS were enrolled in the research work. Anemia according to World Health Organization was seen in 80(40%) and was not present in 120(60%) patients. Among the subjects who had anemia, 16(20%) had a minor AIS, 23(28.75%) had a moderately severe AIS, and 41(51.25%) reported with a severe AIS, according to NIHSS criteria. A notable relationship was found to exist between anemia and stroke severity, (P-value 0.000). Conclusion: Anemia was a commonly found in individuals with acute stroke due to ischemia and had direct relation with severity of stroke. Keywords: Iron deficiency Anemia, severity, ischemic stroke.

scholarly journals CORRELATION BETWEEN NEUTROPHIL-TO-LYMPHOCYTE RATIO AND HIGH SENSITIVITY C REACTIVE PROTEIN WITH SEVERITY AND OUTCOME IN ACUTE ISCHEMIC STROKE PATIENT

2020 ◽  
Vol 7 (8) ◽  
pp. 75-80
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
High Sensitivity ◽  
Neutrophil To Lymphocyte Ratio ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Acute Ischemic Stroke Patient ◽  
Lymphocyte Ratio ◽  
Reactive Protein

Background: Inflammation plays a role in the pathophysiology of cerebral ischemic and also an initial response to brain injury. Inflammation involving Blood and Brain Barrier disturbance, leukocyte infiltration, endothelial cells activation, oxidant and inflammatory mediator buildups which can develop rapidly within hours and can cause secondary injury to brain tissues Objectives: To determine the correlation between Neutrophil-to-Lymphocyte Ratio (NLR) and High Sensitivity C Reactive Protein (hsCRP) with severity and outcome in acute ischemic stroke patients Methods: This study used a cross-sectional design approach. Sampling was done at H. Adam Malik General Hospital Medan and taken as many as 38 subjects. NLR and hsCRP were examined on the first day of admission. Severity was assessed by using the National Institutes of Health Stroke Scale and the outcome was assessed by using the Modified Ranking Scale on the first and fourteenth day of admission. The data analysis used the contingency coefficient correlation test and gamma test. Results: Demographic characteristics of the subjects are; the average age is 62 years old, the highest educational level is high school graduate, and the most occupation is unemployed. There is a positive, moderate, and significant correlation between NLR and severity of acute ischemic stroke (r=0.511; p=0.001). There is a positive, moderate, and significant correlation between NLR and the outcome of acute ischemic stroke (r=0.463; p=0.001). There is a positive, very strong, and significant correlation between hsCRP and severity of acute ischemic stroke (r=0.896; p=0.001). There is a positive, strong, and significant correlation between hsCRP and outcome of acute ischemic stroke (r=0.624; p=0.001) Conclusions: There is a positive and significant correlation between NLR and hsCRP with severity and outcome in acute ischemic stroke patients.

scholarly journals COVID-19: HRCT lung pattern, distribution and severity score with clinico-pathological correlation in a tertiary level institution in rural Maharashtra

2021 ◽  
Vol 8 (12) ◽  
pp. 1821
Author(s):  
Kumar Snehil ◽  
Amol S. Bhoite ◽  
Tamboli Asif ◽  
Radha R. Bawage ◽  
Shreya R. Garg ◽  
...  
Keyword(s):  
Predictive Value ◽  
Severity Score ◽  
Pearson Correlation ◽  
Lower Lobe ◽  
Clinical Severity ◽  
Ground Glass ◽  
Common Finding ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
D Dimer

Background: The severe acute respiratory syndrome corona viruses 2 (SARSCoV-2) are enveloped positive sense RNA virus. Most patients of coronavirus disease 2019 (COVID-19) show fever, cough, dyspnoea and myalgia with weakness.Methods: In this retrospective cross-sectional study 502 patients who were RT-PCR positive for COVID-19 participated in our study after informed consent was taken from all patients, during the period of 3 months between July to September 2020. The study was conducted in Department of Radiodiagnosis at Krishna Institute of Medical Sciences in karad. Each HRCT-Lung scan was evaluated for distribution (central or peripheral); findings (like ground glass opacities, interlobular septal thickening). Every lobe was then allotted CT severity score.Results: The threshold cut-off value for HRCT severity score was found to be 8. The parameters achieved with this cut-off value were: sensitivity – 100%, specificity- 95.15%, positive predictive value- 85.7%, negative predictive value – 100%. On application of pearson correlation coefficient between HRCT severity score and pathological parameters, it was found that strongest correlation was found to be with D-dimer values (0.833), then with ESR (0.484) and least with N/L (neutrophil/lymphocyte) ratio (0.350).Conclusions: On imaging, HTCT thorax showed most common involvement to be peripheral, ground glass opacity and crazy paving being most common findings. The most common finding being left and right lower lobe. The ROC curve showed the CT severity score corresponding to clinical severity to be 8. Among pathological parameters, the strongest correlation with CT severity score was found to be with D-dimer.

scholarly journals A study of mean platelet volume in acute ischemic stroke

2021 ◽  
Vol 8 (2) ◽  
pp. 214
Author(s):  
Vivekanand Kamat ◽  
Satish Kinagi ◽  
Anilkumar Patil
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mean Platelet Volume ◽  
Platelet Reactivity ◽  
Statistical Significance ◽  
Clinical Severity ◽  
Stroke Severity ◽  
Ageing Population ◽  
Platelet Volume ◽  
Cross Sectional

Background: A stroke is defined by the abrupt onset of neurological deficit that is attributable to a focal vascular cause. Because of the growth in the number of ageing population, the burden of stroke is likely to increase automatically in the coming future. Mean platelet volume (MPV), a marker of platelet function is a physiological variable of hemostatic importance. Changes in MPV play a more important role in hemostasis than platelet count. Very few studies has looked at the association between mean platelet volume and ischemic stroke. So, the objectives were to study mean platelet volume in acute ischemic stroke, the role of mean platelet volume as an independent risk factor in acute ischemic stroke and to study the association between MPV and outcome in patients with acute ischemic stroke.Methods: A cross sectional analytical study was conducted on 60 patients with ischemic stroke identified based on clinical features and MRI of Brain admitted in Mahadevappa Rampure Medical College, Kalaburgi. Mean platelet volume (MPV) on admission was documented and severity of stroke at the presentation and at discharge was assessed using Modified Rankins scale (MRS).Results: Among 60 patients, 40% of the study patients were aged between 60-80 years and 60% of study population were male and 40% female. The co-morbid conditions present were hypertension in 50%, diabetes mellitus in 41% .The MPV was raised (>12.5fl) in 64 %of the patients. The clinical severity of stroke at presentation as determined by the Modified Rankin‘s scale (MRS) were moderate (20%), moderately severe (35%) and severe disability in 36.7% of cases. In our study MPV showed statistically significant correlation with Ischemic stroke severity. Clinical outcome as assessed by comparing MRS at admission and discharge with presentation MPV showed 25% moderately, 30% moderately severe and 23% were severely disabled. However, no statistical significance was seen.Conclusions: We conclude that MPV is raised in acute ischemic stroke and is an independent predictor of the risk of stroke. Higher MPV are associated with more severe stroke and tend to have poorer outcome. Mean platelet volume an indicator of platelet reactivity is a simple and easy test available in panel of hemogram and can serve as a valuable predictor of severity and outcome in acute ischemic stroke patients.

scholarly journals Prognostic significance of hs-CRP in acute ischemic stroke patients

2018 ◽  
Vol 5 (3) ◽  
pp. 578 ◽  
Author(s):  
Sonika Pandey ◽  
K. K. Kawre ◽  
P. Dwivedi
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Prognostic Significance ◽  
High Sensitivity ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Hs Crp ◽  
Long Term Prognosis

Background: Stroke, a serious neurological disease is a major cause of death and disability throughout world. The pathophysiology of stroke involves inflammatory pathways, oxidative damage, apoptosis, angiogenesis and neuroprotection. High sensitivity C - reactive protein (hs-CRP) is associated with atherosclerosis and predict incident stroke in many patients. Objective of present study was to find out change in pattern of hs-CRP in acute ischemic stroke (AIS) patients during 3-months follow up and its prognostic significance.Methods: Single centre prospective cross-sectional time bound study. 256 were screened and 130 meet the inclusion and exclusion criteria, of which 100 gave informed consent and 80 patients completed the study at 3 months. Demographic, clinical parameters including NIHSS scoring, biochemical analysis was collected at enrolment, discharge and at end of the study.Results: hs-CRP levels in AIS increased significantly (within 24 hours of stroke) and continued to increase further at discharge, while decreased significantly during 3 months follow up. >7mg/dl hs-CRP at admission had 3.5 fold higher risk of mortality. Age >60 years, metabolic syndrome, hyperlipidemic, SBP >160mmHg and hs-CRP > 7 mg/dL increases relative risk in AIS stroke patients by 1.42, 1.09, 1.11, 1.577 and 3.23 fold respectively.Conclusions: hs-CRP increased significantly in AIS patients during 1st weeks of stroke with subsequent gradual decrease by the end of 3 months, the severity scoring system could determine prognosis on admission to ICU while hs-CRP is the main factor determining short as well as long term prognosis. We recommend serial measurements of hs-CRP for prognostication in AIS subjects.

scholarly journals KADAR D-DIMER PLASMA DI STROK ISKEMIK AKUT

2018 ◽  
Vol 21 (2) ◽  
pp. 183
Author(s):  
Yessi Mayke ◽  
Adi Koesoema Aman ◽  
Y. Anwar
Keyword(s):  
Ischemic Stroke ◽  
Positive Predictive Value ◽  
Ct Scan ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Plasma Levels ◽  
Latex Agglutination ◽  
Cross Sectional ◽  
The Brain ◽  
D Dimer

Ischemic stroke is a clinical sign of brain dysfunction or tissue damage caused by lack of blood flow to the brain that disrupts theblood and oxygen requirements in the brain tissue. In Indonesia, stroke is the third ranks after heart disease and malignancy. The promptdiagnosis can reduce morbidity and mortality. CT-scan is the gold standard, but it has some limitations that are difficult to recognize theearly signs of ischemia on the first day and the cost of the related treatment is expensive. Because of these limitations, such case requireanother sign that is noninvasive, sensitive, specific, easier and cheaper to detect the presence of thrombus while the cause of ischemicstroke is D-dimer. This study was design to know the diagnostic value of plasma levels of D-dimer of the CT-scan in acute ischemic strokeby determination. A cross-sectional study was conducted, where forty patients with inclusion criteria were taken from The NeurologyDepartment. The research was done at the Department of Clinical Pathology RSUP.H.Adam Malik/FK USU Medan. CT-scan as the goldstandard for the D-dimer examination Plasma levels of D-dimer using latex agglutination method with a cut-off 500/mL. Statisticalanalysis using a 2×2 table to determine the sensitivity, specificity, positive predictive value, negative predictive value, prevalence and thelikelihood ratio. The result found were as follows: sensitivity 77.7%, specificity 53.8%, positive predictive value 77.7%, negative predictivevalue 53.8%, prevalence 67.5%, likelihood ratio positive 1.74 and the likelihood ratio negative 0.43. Based on this study, the level plasmaD-dimer could possibly can be used as an exclusion diagnostic in acute ischemic stroke case.

Evaluation of the clot burden score (cbs) for acute ischemic stroke (ais) in intent-to-treat patients.

2019 ◽  
Vol 1 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Sarah Yaziz ◽  
Ahmad Sobri Muda ◽  
Wan Asyraf Wan Zaidi ◽  
Nik Azuan Nik Ismail
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Treatment Decision ◽  
Roc Curves ◽  
Significant Negative Correlation ◽  
Clot Burden

Background : The clot burden score (CBS) is a scoring system used in acute ischemic stroke (AIS) to predict patient outcome and guide treatment decision. However, CBS is not routinely practiced in many institutions. This study aimed to investigate the feasibility of CBS as a relevant predictor of good clinical outcome in AIS cases. Methods:  A retrospective data collection and review of AIS patients in a teaching hospital was done from June 2010 until June 2015. Patients were selected following the inclusion and exclusion criteria. These patients were followed up after 90 days of discharge. The Modified Rankin scale (mRS) was used to assess their outcome (functional status). Linear regression Spearman Rank correlation was performed between the CBS and mRS. The quality performance of the correlations was evaluated using Receiver operating characteristic (ROC) curves. Results: A total of 89 patients with AIS were analysed, 67.4% (n=60) male and 32.6% (n=29) female. Twenty-nine (29) patients (33.7%) had a CBS ?6, 6 patients (6.7%) had CBS <6, while 53 patients (59.6%) were deemed clot free. Ninety (90) days post insult, clinical assessment showed that 57 (67.6%) patients were functionally independent, 27 (30.3%) patients functionally dependent, and 5 (5.6%) patients were deceased. Data analysis reported a significant negative correlation (r= -0.611, p<0.001). ROC curves analysis showed an area under the curve of 0.81 at the cut-off point of 6.5. This showed that a CBS of more than 6 predicted a good mRS clinical outcome in AIS patients; with sensitivity of 98.2%, specificity of 53.1%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 21%. Conclusion: CBS is a useful additional variable for the management of AIS cases, and should be incorporated into the routine radiological reporting for acute ischemic stroke (AIS) cases.

scholarly journals Validity of neuron-specific enolase as a prognostic tool in acute ischemic stroke in adults at Suez Canal University Hospital

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Mohammed H. Shash ◽  
Reda Abdelrazek ◽  
Nashwa M. Abdelgeleel ◽  
Rasha M. Ahmed ◽  
Adel H. El-baih
Keyword(s):  
Ischemic Stroke ◽  
Serum Level ◽  
Acute Ischemic Stroke ◽  
Cell Damage ◽  
Neuron Specific Enolase ◽  
Clinical Severity ◽  
University Hospital ◽  
Short Term ◽  
Prediction Of Mortality ◽  
Death Group

Abstract Background Biological markers of acute nerve cell damage can assist in the outcome of acute ischemic stroke, such as neuron-specific enolase (NSE) that have been tested for association with initial severity of stroke, extent of infarction, and functional outcome. Objective To determine short-term prognostic value of the biochemical marker neuron-specific enolase (NSE) in acute ischemic stroke. Methods A cohort study carried out on 37 patients with acute ischemic stroke. Data were gathered in a prepared data sheet. Initial serum NSE level was measured to the patients in the Emergency department within 6 h of the onset of stroke and another measurement after 48 h. National Institute of Health Stroke Scale (NIHSS) was held to the patients at presentation and after 28 days of stroke to determine short-term morbidity and mortality. Results Out of the 37 patients, 31 patients survived (no-death group) and 6 patients died (death group). The mean serum level of neuron-specific enolase at presentation and after 48 h was significantly higher in the death group than in the no-death group. There was a statistically significant positive correlation between neuron-specific enolase (NSE) serum level and clinical severity of stroke (NIHSS) among the patients at presentation (r = 0.737, p = 0.000). Conclusion Neuron-specific enolase (NSE) can be applied as single independent marker for prediction of mortality and short-term morbidity in ischemic stroke patients.

Predictive value of time-variant color-coded multiphase CT angiography (mCTA) regarding clinical outcome of acute ischemic stroke: in comparison with conventional mCTA and CT perfusion

2020 ◽  
pp. 028418512098177
Author(s):  
Yu Lin ◽  
Nannan Kang ◽  
Jianghe Kang ◽  
Shaomao Lv ◽  
Jinan Wang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
Ct Perfusion ◽  
Roc Curves ◽  
Multivariate Logistic Regression Model ◽  
Infarct Core ◽  
Predictive Values ◽  
Significant Difference ◽  
Core Volume

Background Color-coded multiphase computed tomography angiography (mCTA) can provide time-variant blood flow information of collateral circulation for acute ischemic stroke (AIS). Purpose To compare the predictive values of color-coded mCTA, conventional mCTA, and CT perfusion (CTP) for the clinical outcomes of patients with AIS. Material and Methods Consecutive patients with anterior circulation AIS were retrospectively reviewed at our center. Baseline collateral scores of color-coded mCTA and conventional mCTA were assessed by a 6-point scale. The reliabilities between junior and senior observers were assessed by weighted Kappa coefficients. Receiver operating characteristic (ROC) curves and multivariate logistic regression model were applied to evaluate the predictive capabilities of color-coded mCTA and conventional mCTA scores, and CTP parameters (hypoperfusion and infarct core volume) for a favorable outcome of AIS. Results A total of 138 patients (including 70 cases of good outcomes) were included in our study. Patients with favorable prognoses were correlated with better collateral circulations on both color-coded and conventional mCTA, and smaller hypoperfusion and infarct core volume (all P < 0.05) on CTP. ROC curves revealed no significant difference between the predictive capability of color-coded and conventional mCTA ( P = 0.427). The predictive value of CTP parameters tended to be inferior to that of color-coded mCTA score (all P < 0.001). Both junior and senior observers had consistently excellent performances (κ = 0.89) when analyzing color-coded mCTA maps. Conclusion Color-coded mCTA provides prognostic information of patients with AIS equivalent to or better than that of conventional mCTA and CTP. Junior radiologists can reach high diagnostic accuracy when interpreting color-coded mCTA images.

scholarly journals Serum D-dimer level as a biomarker for identifying patients with isolated injury to prevent unnecessary whole-body computed tomography in blunt trauma care

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Rakuhei Nakama ◽  
Ryo Yamamoto ◽  
Yoshimitsu Izawa ◽  
Keiichi Tanimura ◽  
Takashi Mato
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
High Specificity ◽  
Whole Body ◽  
Cutoff Value ◽  
Whole Body Ct ◽  
Isolated Injury ◽  
D Dimer ◽  
Body Ct

Abstract Background Unnecessary whole-body computed tomography (CT) may lead to excess radiation exposure. Serum D-dimer levels have been reported to correlate with injury severity. We examined the predictive value of serum D-dimer level for identifying patients with isolated injury that can be diagnosed with selected-region CT rather than whole-body CT. Methods This single-center retrospective cohort study included patients with blunt trauma (2014–2017). We included patients whose serum D-dimer levels were measured before they underwent whole-body CT. “Isolated” injury was defined as injury with Abbreviated Injury Scale (AIS) score ≤ 5 to any of five regions of interest or with AIS score ≤ 1 to other regions, as revealed by a CT scan. A receiver operating characteristic curve (ROC) was drawn for D-dimer levels corresponding to isolated injury; the area under the ROC (AUROC) was evaluated. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for several candidate cut-off values for serum D-dimer levels. Results Isolated injury was detected in 212 patients. AUROC was 0.861 (95% confidence interval [CI]: 0.815–0.907) for isolated injury prediction. Serum D-dimer level ≤ 2.5 μg/mL was an optimal cutoff value for predicting isolated injury with high specificity (100.0%) and positive predictive value (100.0%). Approximately 30% of patients had serum D-dimer levels below this cutoff value. Conclusion D-dimer level ≤ 2.5 μg/mL had high specificity and high positive predictive value in cases of isolated injury, which could be diagnosed with selected-region CT, reducing exposure to radiation associated with whole-body CT.

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