C-Reactive Protein and Matrix Metalloproteinase-9 Are Associated with Outcome of Ischemic Stroke

BACKGROUND: C-Reactive protein (CRP) and matrix metalloproteinase (MMP)-9 are inflammatory mediators that are often associated with the evolution of stroke. In this study, we aimed to find out whether concentration of these biomarkers were associated with the severity of discharge National Institute of Health Stroke Scale (NIHSS) in ischemic stroke patient.METHODS: In prospective stody, we involved 143 ischemic stroke patient who were admitted to hospital not more than 72 hours after the onset and who met the criteria. The concentration of CRP was assessed by High Sensitivity CRP reagent from Siemens and the concentration of MMP-9 was measure with Quantikine Human MMP-9 (total) Immunoassay from R&D. The outcome of stroke was determined by NIHSS score at discharge.RESULTS: There was a significant correlation between the CRP level and the severity of NIHSS at discharge (r = 0.288, p = 0.000). Subjects with intermediate/high level of CRP had a higher probability to have a moderate or even severe NIHSS (OR = 1.7, p = 0.004). Subjects with high MMP level showed a higher probability to have a severe NIHSS. CONCLUSION: The measurement of CRP and MMP-9 at 48-72 hours after stroke onset were associated with the severity of ischemic stroke based on NIHSS score at discharge

GFAP and S100B Protein Are Associated with Discharged NIHSS of Anterior Circulation Ischemic Stroke

BACKGROUND: Patient with larger ischemic lesion will suffer more severe neurogical deficit. The utility of MRI for lesion size measurement is still limited, therefore additional approach was pursued through examination of markers released by damaged brain cell, GFAP and S100B protein. The aim of this study is to know whether both markers are associated with the neurological deficit of anterior circulation ischemic stroke. METHODS: This observational prospective study enrolled 74 patients with anterior circulation ischemic stroke diagnosis. GFAP and S100B protein were measured with ELISA using blood collected at 48 to 72 hours after onset. The neurological deficit was assessed with NIHSS ad discharged.RESULTS: There was a significant association between GFAP level and discharged NIHSS (p=0.008) with 100% sensitivity and 100% negative predictive value. S100B protein also showed a significant correlation with discharged NIHSS (r=0.488; p=0.000) and this correlation could be described with an equation (OR=1.009; 95% CI=1.0003-1.0188; p=0.044). S100B protein at 78.3215 ng/L would give true prediction as 73.9% (95% CI=62.7%-85.2%, p=0.001). CONCLUSIONS: GFAP and S100B protein that were measured at 48 to 72 hours after onset were significantly associated with NIHSS at discharge