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Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke

Laura Ramiro1, Laura Abraira2,3, Manuel Quintana2,3

  • 1Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Life (Basel, Switzerland)
|February 13, 2021
PubMed

Insights

Identifying specific blood biomarkers like endostatin, tumor necrosis factor receptor-1 (TNF-R1), and interleukin-6 (IL-6) can help predict long-term mortality after ischemic stroke. These biomarkers, combined with clinical factors, improve risk assessment for stroke patients.

Area of Science:

  • Biomedical research
  • Clinical neurology
  • Translational medicine

Background:

  • Stroke is a leading global cause of death and disability.
  • Accurate prediction of long-term mortality after stroke remains a significant clinical challenge.
  • Identifying novel prognostic biomarkers is crucial for improving patient management and outcomes.

Purpose of the Study:

  • To identify blood biomarkers measured during acute ischemic stroke that predict long-term mortality.
  • To evaluate the independent predictive value of a 14-biomarker panel in conjunction with clinical factors.
  • To assess the association of specific biomarkers with stroke-related mortality.

Main Methods:

  • Prospective recruitment of 941 ischemic stroke patients in the Stroke-Chip study.
  • Analysis of a 14-biomarker panel using immunoassays in blood samples at hospital admission.
  • Application of multiple Cox regression models for multivariate analysis of clinical variables and biomarkers, with Z-score standardization.

Main Results:

  • Age, female sex, hypertension, glycemia, and NIHSS score were independent predictors of long-term mortality.
  • Elevated levels of endostatin, TNF-R1, and IL-6 (all > quartile 2) were independently associated with long-term mortality.
  • Combining these three biomarkers increased mortality risk by up to 69% and improved predictive discrimination.
  • Endostatin > quartile 3 independently predicted mortality due to stroke.

Conclusions:

  • Circulating levels of endostatin, TNF-R1, and IL-6 are valuable predictors of long-term mortality after ischemic stroke.
  • These biomarkers, when added to clinical predictors, enhance the accuracy of mortality risk assessment.
  • The findings suggest potential for incorporating these biomarkers into clinical practice for post-stroke prognostication.

Keywords:
IL-6TNF-R1biomarkerendostatinischemic strokemortality

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