A Systematic Review and Meta-Analysis of Molecular Biomarkers Associated with Early Neurological Deterioration Following Acute Stroke

Background: Early neurological deterioration (END) following acute stroke is associated with poorer long-term outcomes. Identification of patients at risk could assist early monitoring and treatment decisions. This review summarised the evidence describing non-radiological biomarkers for END.Summary: Electronic searches from January 1990 to March 2017 identified studies reporting a blood/cerebrospinal fluid (CSF)/urine biomarker measurement within 24 h of acute stroke and at least 2 serial assessments of clinical neurological status (#x3c; 24 h and #x3c; 7 days). Out of 12,895 citations, 82 studies were included, mostly focusing on ischaemic stroke. Using higher neurological thresholds, the n-weighted END incidence for ischaemic stroke was 11.9% (95% CI 11.4 –12.4%) and 18.6% (17.9–19.2%) for lower thresholds. Incidence decreased with advancing study publication year (Pearson r-squared 0.23 and 0.15 for higher and lower threshold studies). After classification into 3 broad categories, meta-analysis showed that biomarkers associated with increased EN D risk (n; fixed-effects mean difference; 95% CI) were “metabolic” (glucose [n = 9,481; 0.90 mmol/L; 0.74 –1.06], glycosylated haemoglobin [n = 3,146; 0.33%; 0.19 –0.46], low-density lipoprotein [n = 4,839; 0.13 mmol/L; 0.06 –0.21], total cholesterol [n = 4,762; 0.21 mmol/L; 0.11 –0.31], triglycerides [n = 4,820; 0.11 mmol/L; 0.06 –0.17], urea [n = 1,351; 0.55 mmol/L; 0.14 &nda...
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research

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Authors: Kotlęga D, Gołąb-Janowska M, Meller A, Bajer-Czajkowska A, Zembroń-Łacny A, Nowacki P, Banach M Abstract Introduction: Statins are widely used in stroke patients. The AHA/ASA guidelines recommend aggressive statin therapy in atherosclerotic stroke patients. Their beneficial effects are due to both their hypolipemic and pleiotropic properties. The aim of this study was to establish potential benefits from statin use in ischemic stroke patients with the diagnosis of atrial fibrillation (AF). Material and methods: Ischemic stroke patients with AF were enrolled in the study. Group I, the statin group ...
Source: Archives of Medical Science - Category: General Medicine Tags: Arch Med Sci Source Type: research
In conclusion, in this series the most prevalent stroke mechanism was SUE, mainly embolic stroke of undetermined source. The outcome was excellent regardless of stroke mechanism.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: Multimodality MRI screening for AIS symptoms for ET is feasible. Optimizing each center ’s protocol and the utilization of MRI with DWI only may be a time-saving alternative.Intervent Neurol 2019;8:135 –143
Source: Interventional Neurology - Category: Neurology Source Type: research
In conclusion, activation of peripheral immune-inflammatory, oxidative and biochemical pathways is critically associated with mortality after AIS. Our results may contribute to identify new biomarker sets, which may predict post- stroke death, as well as suggest that IL-6 trans-signaling coupled with redox imbalances may be possible new targets in the prevention of short-term outcome AIS death.
Source: Metabolic Brain Disease - Category: Neurology Source Type: research
Abstract The ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) is an objective approach to predicting poor outcomes in acute ischemic stroke (AIS). The impact of TG/HDL-C on hemorrhagic transformation (HT) after AIS remains unknown. The aim of this study was to explore the accurate effect of TG/HDL-C on HT after AIS. We enrolled a total of 1423 patients with AIS in the training cohort from a prospective, consecutive hospital-based stroke registry. Of the 1423 patients, HT occurred in 155 (10.89%) patients. The incidence of HT after AIS was significantly increased when there were low levels...
Source: Aging - Category: Biomedical Science Authors: Tags: Aging (Albany NY) Source Type: research
This study describes subsequent cardiovascular events and deaths by low-density lipoprotein cholesterol (LDL-C) level among patients with atherosclerotic cardiovascular disease (ASCVD) receiving moderate to high-intensity statins. Olmsted County, MN residents with index ASCVD (myocardial infarction, unstable angina, coronary revascularization, ischemic stroke/transient ischemic attack) occurring between 2005-2012 were identified, and those with a prescription for a moderate- or high-intensity statin and an LDL-C measurement in the 90 days after index were included.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Conclusions: The primary prevention of cardiovascular disease via a reduction in dietary salt consumption appeared much more effective than secondary or tertiary prevention approaches. Our simple but comprehensive model offers a potentially attractive methodological approach that might now be extended and replicated in other contexts and populations. PMID: 30838048 [PubMed - in process]
Source: Computational and Mathematical Methods in Medicine - Category: Statistics Tags: Comput Math Methods Med Source Type: research
CONCLUSION: rs2066715 was found to interact with egg consumption in modifying the risk of carotid plaque in the Chinese population. PMID: 30828007 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Conclusions: Increased HbA1c values seem to contribute to plaque instability through the formation of a thin fibrous cup. Thus, of the carotid artery plaque parameters including fibrous cup thickness, plaque rupture, lipid core, inflammation, intraplaque hemorrhage, thrombus, calcification, necrotic core, and neovascularization, fibrous cup thickness is the only histomorphological feature that affected by HbA1c.
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research
ConclusionsIn the oldest old ( ≥ 80 years), statin users were fewer and had more often an established indication, suggesting that physicians extrapolate scientific evidence for beneficial effects in younger age groups to the oldest, but require a more solid ground for treatment. As the oldest old, nursing home residents, and those with multi-dose drug-dispensing were statin users to a lesser extent, physicians may often refrain from treatment in those with lower life expectancy, either due to age or to severely reduced health status. In both age groups, our results however also indicate some over- as well as undertreat ment.
Source: European Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Source Type: research
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