Predictive value of circulating interleukin-6 and heart-type fatty acid binding protein for three months clinical outcome in acute cerebral infarction: multiple blood markers profiling study
Open Access
- 1 January 2013
- journal article
- research article
- Published by Springer Science and Business Media LLC in Critical Care
- Vol. 17 (2), R45
- https://doi.org/10.1186/cc12564
Abstract
There is no single blood marker for predicting the prognosis in ischemic stroke. A combination of multiple blood markers may enhance the ability to predict long-term outcome following ischemic stroke. Blood concentrations of neuronal markers (neuron-specific enolase, visinin-like protein 1, heart type fatty acid binding protein (hFABP) and neuroglobin), astroglial markers (S100B and glial fibrillary acidic protein), inflammatory markers (IL-6, TNF-α, and C-reactive protein), blood-brain barrier marker (matrix metalloproteinase 9), and haemostatic markers (D-dimer and PAI-1) were measured within 24 hours after stroke onset. The discrimination and reclassification for favorable and poor outcome were compared after adding individual or a combination of blood markers to the clinical model of stroke outcome. In multivariate analysis, natural log-transformed (log) IL-6 (odds ratio (OR): 1.75, 95% CI: 1.25 to 2.25, P = 0.001) and loghFABP (OR: 3.23, 95% CI: 1.44 to 7.27, P = 0.005) were independently associated with poor outcome. The addition of a single blood marker to the clinical model did not improve the discriminating ability of the clinical model of stroke outcome. However, the addition of the combination of logIL-6 and loghFABP to the clinical model showed improved discrimination (area under receiver operating characteristic (AUROC) curve: 0.939 versus 0.910, P = 0.03) and reclassification performance (net reclassification improvement index: 0.18, P = 0.005). A combination of circulating IL-6 and hFABP level has an additive clinical value for the prediction of stroke outcome.This publication has 39 references indexed in Scilit:
- Interleukin-6 as an Early Predictor for One-Year Survival following an Ischaemic Stroke/Transient Ischaemic AttackInternational Journal of Stroke, 2010
- IL-6: an early marker for outcome in acute ischemic strokeActa Neurologica Scandinavica, 2005
- Utilization of Intravenous Tissue Plasminogen Activator for Acute Ischemic StrokeArchives of Neurology, 2004
- Predicting functional outcome in acute stroke: comparison of a simple six variable model with other predictive systems and informal clinical predictionJournal of Neurology, Neurosurgery & Psychiatry, 2004
- Peak plasma interleukin-6 and other peripheral markers of inflammation in the first week of ischaemic stroke correlate with brain infarct volume, stroke severity and long-term outcomeBMC Neurology, 2004
- Fatty Acid Binding Protein as a Serum Marker for the Early Diagnosis of StrokeMolecular & Cellular Proteomics, 2004
- Prediction of early clinical severity and extent of neuronal damage in anterior-circulation infarction using the initial serum neuron-specific enolase level.Archives of Neurology, 2003
- Temporal Profile and Cellular Localization of Interleukin-6 Protein after Focal Cerebral Ischemia in RatsJournal of Cerebral Blood Flow & Metabolism, 1999
- Early Neurobehavioral Outcome After Stroke Is Related to Release of Neurobiochemical Markers of Brain DamageStroke, 1999
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993