22. European Stroke Conference 91 Stroke prognosis Association between silent brain infarction and biomarkers in acute lacunar infarct patients H.S. Kwon1, W.H. Jho2, Y.S. Kim3, J.H. Kim4, S.H. Kim5, H.T. Kim6, Y.J. Lee7, K.Y. Lee8, H.Y. Kim9, Y.B. Lee10, S.H. Koh11 Hanyang University Hospital, Seoul, SOUTH KOREA1, Hanyang University Hospital, Seoul, SOUTH KOREA2, Hanyang University Hospital, Seoul, SOUTH KOREA3, Hanyang University Hospital, Seoul, SOUTH KOREA4, Hanyang University Hospital, Seoul, SOUTH KOREA5, Ha-nyang University Hospital, Seoul, SOUTH KOREA6, Hanyang University Hospital, Seoul, SOUTH KOREA7, Hanyang University Hospital, Seoul, SOUTH KOREA8, Hanyang University Hospital, Seoul, SOUTH KOREA9,Gachon University Gil Medical Center, Incheon, 10, Hanyang University Hospital, Seoul, SOUTH KOREA11 Background: Prediction of stroke outcome is essential, but outcome predictors are unclear. Silent brain infarctions (SBIs) are associated with prognosis after stroke, although the mechanisms remain unclear. In this study, we investigated associations in acute lacunar infarct patients between SBIs and biomarkers including vascular endothelial growth factor (VEGF), stromal cell-derived factor-1α (SDF-1α), macrophage migration inhibitory factor (MIF) and high mobility group box-1 (HMGB1), which reported to play roles in neurovascular remodeling or inflammation. Methods: From January 2009 to March 2011, 68 consecutive patients with first-ever lacunar infarction within 24 hours of symptom onset were included. We excluded patients with inflammatory disease, cancers and use of rtPA. Serum samples were assessed with ELISA kit. Clinical findings were obtained at admission and after 3 months of stroke onset. Results: SBIs were noted in 31 (45%) of the 68 patients. Patients with SBIs were associated with hypertension (p=0.055) and advanced leukoaraiosis (p<0.001) on univariate analysis. Patients with SBIs had better outcome at 3 months (p=0.038) after stroke onset. Serum VEGF were higher and SDF-1α were lower in patients with silent infarctions (p=0.035 and p<0.001). However, MIF and HMGB1 were not different from each groups. (Figure 1) Logistic re-gression analysis showed that VEGF and SDF‐1α were independently associated with the presence of SBIs. (Table 1) Conclusion: In lacunar infarction patients, SBIs were associated with favorable outcome. In addition, favorable outcome was associated with early expression of VEGF. We suggest that this association may affected by expression of VEGF. On the other hand, SDF-1α may reflected the severity of lacunar infarction. So lesser SDF-1α may associated with better outcome in lacunar infarction patient, but further is in need. 328 © 2013 S. Karger AG, Basel Scientific Programme Table 1 Logistic regression analysis of previous silent brain infarction group and previous no infarc-tion group Unadjusted OR Model 1 p Model 2 p VEGF 1.100 (1.000- 1.210) 1.104 (1.005- 1.213) 0.040* 1.118 (0.987- 1.266) 0.078 SDF-1 0.772 (0.689- 0.865) 0.738 (0.638- 0.853) 0.416 (0.197- 0.882) 0.022* MIF 1.008 (0.870- 1.168) 0.999 (0.861- 1.161) 0.994 1.011 (0.852- 1.199) 0.904 HMGB1 1.000 (1.000- 1.000) 1.000 (1.000- 1.000) 0.444 1.000 (0.999- 1.000) 0.270 p for multivariate models. All factor parameters are “pg/ml” *indicates independent risk factors associated with the presences of silent brain infarctions in lacunar stroke patients Data are presented as odds ratios (95% confidence interval) associated with 100pg/ml increase in SDF-1α, HMGB1; 10pg/ml increase in VEGF, MIF Model 1: Adjusted for age and gender Model 2: Additionally adjusted for hypertension, diabetes mellitus, white blood cell, platelet, fasting glucose, erythrocyte sedimentation rate.
Karger_ESC London_2013
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