Fuck, fuck, fuck you lazy idiots. 10 million survivors a year don't want predictions they want solutions. Have you never talked to any stroke survivors? My god, the lack of professionalism in the stroke world is appalling. They are not even trying to solve stroke.
Multiple biomarkers covering distinct pathways for predicting outcomes after ischemic stroke
Downloads
0
This article requires a subscription to view the full text. If
you have a subscription you may use the login form below to view the
article. Access to this article can also be purchased.
Abstract
Objective To study the prognostic significance of multiple novel biomarkers in combination after ischemic stroke.
Methods
We derived data from the China Antihypertensive Trial in Acute Ischemic
Stroke, and 12 informative biomarkers were measured. The primary
outcome was the combination of death and major disability (modified
Rankin Scale score ≥3) at 3 months after ischemic stroke, and secondary
outcomes included major disability, death, and vascular events.
Results
In 3,405 participants, 866 participants (25.4%) experienced major
disability or died within 3 months. In multivariable analyses, elevated
high-sensitive C-reactive protein, complement C3, matrix
metalloproteinase-9, hepatocyte growth factor, and
antiphosphatidylserine antibodies were individually associated with the
primary outcome. Participants with a larger number of elevated
biomarkers had increased risk of all study outcomes. The adjusted odds
ratios (95% confidence intervals) of participants with 5 elevated
biomarkers were 3.88 (2.05–7.36) for the primary outcome, 2.81
(1.49–5.33) for major disability, 5.67 (1.09–29.52) for death, and 4.00
(1.22–13.14) for vascular events, compared to those with no elevated
biomarkers. Simultaneously adding these 5 biomarkers to the basic model
with traditional risk factors led to substantial reclassification for
the combined outcome (net reclassification improvement 28.5%, p < 0.001; integrated discrimination improvement 2.2%, p < 0.001) and vascular events (net reclassification improvement 37.0%, p = 0.001; integrated discrimination improvement 0.8%, p = 0.001).
Conclusion
We observed a clear gradient relationship between the numbers of
elevated novel biomarkers and risk of major disability, mortality, and
vascular events. Incorporation of a combination of multiple biomarkers
observed substantially improved the risk stratification for adverse
outcomes in ischemic stroke patients.
Glossary
- aCL=
- anticardiolipin antibodies;
- aPS=
- antiphosphatidylserine antibodies;
- BP=
- blood pressure;
- CATIS=
- China Antihypertensive Trial in Acute Ischemic Stroke;
- CI=
- confidence interval;
- eGFR=
- estimated glomerular filtration rate;
- HGF=
- hepatocyte growth factor;
- hsCRP=
- high-sensitive C-reactive protein;
- IDI=
- integrated discrimination improvement;
- IgG=
- immunoglobulin G;
- IL-6=
- interleukin-6;
- Lp-PLA2=
- lipoprotein-associated phospholipase A2;
- MMP-9=
- matrix metalloproteinase-9;
- mRS=
- modified Rankin Scale;
- NIHSS=
- NIH Stroke Scale;
- NRI=
- net reclassification improvement;
- NT-proBNP=
- N-terminal pro-brain natriuretic peptide;
- OR=
- odds ratio;
- RF=
- rheumatoid factor
Footnotes
- ↵* These authors contributed equally to this work.
- Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Editorial page 157
- Received April 30, 2018.
- Accepted in final form September 12, 2018.
- © 2018 American Academy of Neurology
No comments:
Post a Comment