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Serum creatinine does not improve early classification of ischemic stroke caused by small artery occlusion

Adam B Cohen1, Robert A Taylor, Steven R Messé

  • 1Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 2, 2007
PubMed

Insights

Impaired kidney function does not help identify small-artery occlusion (SAO) stroke subtypes. Lacunar syndrome is only a reliable predictor of SAO in diabetic patients with acute ischemic stroke.

Area of Science:

  • Neurology
  • Nephrology
  • Cardiovascular Research

Background:

  • Accurate ischemic stroke subtyping is crucial but challenging.
  • Microvascular disease is a systemic condition often linked to impaired renal function.
  • Small-artery occlusion (SAO) is a major subtype of ischemic stroke.

Purpose of the Study:

  • To investigate the correlation between impaired renal function and the small-artery occlusion (SAO) stroke subtype.
  • To determine if serum creatinine levels can predict SAO in acute ischemic stroke patients.
  • To assess the utility of lacunar syndrome as a predictor of SAO, particularly in diabetic patients.

Main Methods:

  • Retrospective cohort study of consecutive ischemic stroke patients.
  • Analysis of clinical and laboratory data at admission.
  • Comparison of baseline serum creatinine levels with final stroke subtype determination.

Main Results:

  • No significant correlation was found between elevated serum creatinine and the SAO subtype.
  • Lacunar syndrome was the most helpful predictor of SAO, but only in patients with diabetes.
  • The positive predictive value of lacunar syndrome for SAO in diabetic patients was 67%.

Conclusions:

  • Impaired renal function, indicated by serum creatinine, does not aid in the early identification of SAO stroke.
  • Lacunar syndrome is an effective early indicator of SAO exclusively in diabetic stroke patients.
  • Current biomarkers and clinical signs have limitations in accurately subtyping acute ischemic stroke, especially SAO.
Abstract

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