Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke

Stroke is a major cause of disability and death globally, and prediction of mortality represents a crucial challenge. We aimed to identify blood biomarkers measured during acute ischemic stroke that could predict long-term mortality. Nine hundred and forty-one ischemic stroke patients were prospecti...

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Autores: Ramiro, Laura, Abraira, Laura, Quintana, Manuel, García Rodríguez, Paula, Santamarina, Estevo, Álvarez Sabín, Jose, Zaragoza, Josep, Hernández Pérez, María, Ustrell, Xavier, Lara, Blanca, Terceño, Mikel, Bustamante, Alejandro, Montaner, Joan
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/175800
Acceso en línea:https://hdl.handle.net/2445/175800
Access Level:acceso abierto
Palabra clave:Isquèmia
Marcadors bioquímics
Mortalitat
Ischemia
Biochemical markers
Mortality
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spelling Blood Biomarkers to Predict Long-Term Mortality after Ischemic StrokeRamiro, LauraAbraira, LauraQuintana, ManuelGarcía Rodríguez, PaulaSantamarina, EstevoÁlvarez Sabín, JoseZaragoza, JosepHernández Pérez, MaríaUstrell, XavierLara, BlancaTerceño, MikelBustamante, AlejandroMontaner, JoanIsquèmiaMarcadors bioquímicsMortalitatIschemiaBiochemical markersMortalityStroke is a major cause of disability and death globally, and prediction of mortality represents a crucial challenge. We aimed to identify blood biomarkers measured during acute ischemic stroke that could predict long-term mortality. Nine hundred and forty-one ischemic stroke patients were prospectively recruited in the Stroke-Chip study. Post-stroke mortality was evaluated during a median 4.8-year follow-up. A 14-biomarker panel was analyzed by immunoassays in blood samples obtained at hospital admission. Biomarkers were normalized and standardized using Z-scores. Multiple Cox regression models were used to identify clinical variables and biomarkers independently associated with long-term mortality and mortality due to stroke. In the multivariate analysis, the independent predictors of long-term mortality were age, female sex, hypertension, glycemia, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Independent blood biomarkers predictive of long-term mortality were endostatin > quartile 2, tumor necrosis factor receptor-1 (TNF-R1) > quartile 2, and interleukin (IL)-6 > quartile 2. The risk of mortality when these three biomarkers were combined increased up to 69%. The addition of the biomarkers to clinical predictors improved the discrimination (integrative discriminative improvement (IDI) 0.022 (0.007-0.048), p < 0.001). Moreover, endostatin > quartile 3 was an independent predictor of mortality due to stroke. Altogether, endostatin, TNF-R1, and IL-6 circulating levels may aid in long-term mortality prediction after stroke.MDPI2021202120212021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion11 p.application/pdfhttps://hdl.handle.net/2445/175800Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3390/life11020135Life, 2021, vol. 11, num. 2https://doi.org/10.3390/life11020135cc by (c) Ramiro et al., 2021http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1758002026-05-29T05:05:01Z
dc.title.none.fl_str_mv Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
title Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
spellingShingle Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
Ramiro, Laura
Isquèmia
Marcadors bioquímics
Mortalitat
Ischemia
Biochemical markers
Mortality
title_short Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
title_full Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
title_fullStr Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
title_full_unstemmed Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
title_sort Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke
dc.creator.none.fl_str_mv Ramiro, Laura
Abraira, Laura
Quintana, Manuel
García Rodríguez, Paula
Santamarina, Estevo
Álvarez Sabín, Jose
Zaragoza, Josep
Hernández Pérez, María
Ustrell, Xavier
Lara, Blanca
Terceño, Mikel
Bustamante, Alejandro
Montaner, Joan
author Ramiro, Laura
author_facet Ramiro, Laura
Abraira, Laura
Quintana, Manuel
García Rodríguez, Paula
Santamarina, Estevo
Álvarez Sabín, Jose
Zaragoza, Josep
Hernández Pérez, María
Ustrell, Xavier
Lara, Blanca
Terceño, Mikel
Bustamante, Alejandro
Montaner, Joan
author_role author
author2 Abraira, Laura
Quintana, Manuel
García Rodríguez, Paula
Santamarina, Estevo
Álvarez Sabín, Jose
Zaragoza, Josep
Hernández Pérez, María
Ustrell, Xavier
Lara, Blanca
Terceño, Mikel
Bustamante, Alejandro
Montaner, Joan
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Isquèmia
Marcadors bioquímics
Mortalitat
Ischemia
Biochemical markers
Mortality
topic Isquèmia
Marcadors bioquímics
Mortalitat
Ischemia
Biochemical markers
Mortality
description Stroke is a major cause of disability and death globally, and prediction of mortality represents a crucial challenge. We aimed to identify blood biomarkers measured during acute ischemic stroke that could predict long-term mortality. Nine hundred and forty-one ischemic stroke patients were prospectively recruited in the Stroke-Chip study. Post-stroke mortality was evaluated during a median 4.8-year follow-up. A 14-biomarker panel was analyzed by immunoassays in blood samples obtained at hospital admission. Biomarkers were normalized and standardized using Z-scores. Multiple Cox regression models were used to identify clinical variables and biomarkers independently associated with long-term mortality and mortality due to stroke. In the multivariate analysis, the independent predictors of long-term mortality were age, female sex, hypertension, glycemia, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Independent blood biomarkers predictive of long-term mortality were endostatin > quartile 2, tumor necrosis factor receptor-1 (TNF-R1) > quartile 2, and interleukin (IL)-6 > quartile 2. The risk of mortality when these three biomarkers were combined increased up to 69%. The addition of the biomarkers to clinical predictors improved the discrimination (integrative discriminative improvement (IDI) 0.022 (0.007-0.048), p < 0.001). Moreover, endostatin > quartile 3 was an independent predictor of mortality due to stroke. Altogether, endostatin, TNF-R1, and IL-6 circulating levels may aid in long-term mortality prediction after stroke.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/175800
url https://hdl.handle.net/2445/175800
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/life11020135
Life, 2021, vol. 11, num. 2
https://doi.org/10.3390/life11020135
dc.rights.none.fl_str_mv cc by (c) Ramiro et al., 2021
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Ramiro et al., 2021
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11 p.
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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