,Predicting functional outcome of ischemic stroke patients in Romania based on plasma CRP, sTNFR-1,

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In cerebral ischemia,evaluation of multiple biomarkers involved in various pathological pathways is a useful tool in assessing the outcome of the patients even from the early stages of the disease.In this study we investigated the utility of a panel of 5 peripheral biomarkers of inflammatory status,neuronal destruction and secondary fibrinolysis in the acute phase of ischemia,and evaluated the impact of these biomarkers on functional outcome after ischemic stroke.The 5 biomarkers (plasma CRP,D-Dimers,sTNFR-1,NGAL and NSE) were measured using a biochip array technology.Eighty nine patients in Romania were divided into 2 subgroups using the modified Rankin Scale evaluated at 3 months after ischemic stroke;the possible impact of analyzed biomarkers on unfavorable functional outcome wastested by binomial logistic regression.The subgroup with unfavorable outcome had higher concentrations of CRP,NGAL,sTNFR-1 and D-dimers,but CRP and NGAL values were not statistically different between the two subgroups.The univariate logistic regression analysis of plasma biomarkers revealed that CRP,D-Dimers,NGAL,sTNFR-1 were significant predictors of unfavorable clinical outcome.In the case of D-Dimers and sTNFR-1 we noticed an increased discrimination ability (versus baseline clinical model) to classify poor functional outcome with a tendency toward statistical signification.During the acute phase of the ischemic stroke,plasma concentrations of CRP,D-Dimers and sTNFR-1 were elevated in unfavorable outcome patients.D-Dimers and sTNFR-1 were independent predictors of poor outcome at 3 months after ischemic stroke.The biochip array technology offers the possibility to simultaneously measure several parameters involved in multiple pathophysiological pathways,in a small sample volume.
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