TY - JOUR
T1 - The initial acute phase response predicts long-term stroke recovery
AU - Clark, Wayne M.
AU - Beamer, Nancy B.
AU - Wynn, Michael
AU - Coull, Bruce M.
N1 - Funding Information:
There is increasing evidence that inflammatory responses play an important role in the potentiation of central nervous system (CNS) ischemia. ~ Much of this acute phase response (APR) appears to be mediated by interleukins, a multifunctional subclass of cytokines. 2 Interleukin-6 (IL-6) stimulates hepatocytes to synthesize fibrinogen and other prothrombotic proteins at the expense of serum albumin. 2 Consequently, indicators of the APR in clinical stroke indude elevated plasma IL-6, fibrinogen, white blood cell count, and reduced serum albumin. We have shown that plasma IL-6 and fibrinogen levels are higher in stroke patients than in matched controls, 3 and several studies have shown that initial levels of IL-6 correlate with infarct size and predict stroke From the Oregon Stroke Center, Department of Neurology, Oregon Health Sciences University, Portland, OR. Received June 23,1997; accepted September 25,1997. Supported in part by an NIH:CIDA award (W.M.C.); and NINDS 2PO1 NS17493-08 (B.M.C.). Address reprint requests to Wayne M. Clark, MD, Department of Neurology L104, Oregon Health Sciences University, 3181 SW Sam Jackson Pk Rd, Portland, OR 97201. Copyright 9 1998 by National Stroke Association 1052-3057/98/0702-000553.00/0 recurrenceA 6 However, whether IL-6 and other APR indices predict long-term stroke recovery has not been evaluated.
PY - 1998/3
Y1 - 1998/3
N2 - Indicators of an acute phase response (APR) in acute ischemic stroke have been shown to correlate with infarct size and predict stroke recurrence. In this study, we examined how well the APR indicators predicted long-term stroke recovery compared with standard clinical predictors of recovery. Plasma levels of interleukin-6 (IL-6), fibrinogen, white blood cells (WBCs), and serum albumin were measured within 4±2 days of onset in 131 stroke patients who were free of apparent infections. Standard clinical predictors included initial National Institutes of Health Stroke Scale (NIHSS), infarct size on computed tomography (CT), and Glasgow scale. The individual correlations with 6-month Glasgow outcome were IL-6, 0.42; fibrinogen, 0.24; WBC, 0.35; albumin, 0.47; NIHSS, 0.53; infarct size, 0.19; and initial Glasgow, 0.57. (all P<.005). Multiple regression analysis yielded an adjusted R2 of .31 for the APR indicators, compared with .38 for the clinical variables. These results indicate that the initial APR is highly correlated with 6-month stroke recovery and that this correlation approaches that observed with standard clinical predictors.
AB - Indicators of an acute phase response (APR) in acute ischemic stroke have been shown to correlate with infarct size and predict stroke recurrence. In this study, we examined how well the APR indicators predicted long-term stroke recovery compared with standard clinical predictors of recovery. Plasma levels of interleukin-6 (IL-6), fibrinogen, white blood cells (WBCs), and serum albumin were measured within 4±2 days of onset in 131 stroke patients who were free of apparent infections. Standard clinical predictors included initial National Institutes of Health Stroke Scale (NIHSS), infarct size on computed tomography (CT), and Glasgow scale. The individual correlations with 6-month Glasgow outcome were IL-6, 0.42; fibrinogen, 0.24; WBC, 0.35; albumin, 0.47; NIHSS, 0.53; infarct size, 0.19; and initial Glasgow, 0.57. (all P<.005). Multiple regression analysis yielded an adjusted R2 of .31 for the APR indicators, compared with .38 for the clinical variables. These results indicate that the initial APR is highly correlated with 6-month stroke recovery and that this correlation approaches that observed with standard clinical predictors.
KW - Cytokines
KW - Interleukin-6
KW - Stroke
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U2 - 10.1016/S1052-3057(98)80139-0
DO - 10.1016/S1052-3057(98)80139-0
M3 - Article
C2 - 17895069
AN - SCOPUS:0043091037
SN - 1052-3057
VL - 7
SP - 128
EP - 131
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 2
ER -