Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Associations between admission levels of multiple biomarkers and subsequent worse outcomes in acute ischemic stroke patients
First author：Wei-Li Jia
Corresponding author：Hong-Qiu Gu,Zi-Xiao Li
essential_information
- Person in charge：Wei-Li Jia
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20230206
- Published time：2023-11-17
2023-11-17
Published articles
Journal：Journal of Cerebral Blood Flow & Metabolism
Publication type: Article
IF(IF): 6.3
PMID: 37975323 Link To Pubmed Full text Download
Background And Purpose
The modified Rankin Scale change score (ΔmRS) is useful for evaluating acute poststroke functional improvement or deterioration. We investigated the relationship between multiple biomarkers and ΔmRS in acute ischemic stroke.
Method
We included 6931 patients with acute ischemic stroke (average age 62.3±11.3 years, 2174 (31.4%) female) enrolled from the Third China National Stroke Registry (CNSR-III) and 15 available biomarkers. Worse outcomes at 3 months were defined as ΔmRS3m-discharge≥1 (mRS3m-mRSdischarge=ΔmRS3m-discharge). Cox models or logistic regression models were used to analyze the relationship between worse outcomes and biomarkers. Hazard ratios (HRs) and odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated.
Conclusion
This study indicated that WBCs, hs-CRP, IL-6, IL-1Ra, and YKL-40 were significantly associated with worse outcomes in acute ischemic stroke patients, and all inflammatory biomarkers except YKL-40 were independent predictors of worse outcomes at 3 months.
Main results
At 3-months poststroke, 1026 (14.8%) patients experienced worse outcomes. The highest quartiles of white blood cells (WBCs) (aOR [95%CI],1.37 [1.12-1.66]), high-sensitivity C-reactive protein (hs-CRP) (1.37 [1.12-1.67]), interleukin-6 (IL-6) (1.43 [1.16-1.76]), interleukin-1 receptor antagonist (IL-1Ra) (1.46 [1.20-1.78]) and YKL-40 (1.31 [1.06-1.63]) were associated with an increased risk of worse outcomes at 3 months. Results remained stable except for YKL-40 when simultaneously adding multiple biomarkers to the basic traditional-risk-factor model. Similar results were observed at 6 and 12 months after stroke.