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Nucleosomes as a new prognostic marker in early cerebral stroke.
- Source :
-
Journal of neurology [J Neurol] 2007 May; Vol. 254 (5), pp. 617-23. Date of Electronic Publication: 2007 Apr 06. - Publication Year :
- 2007
-
Abstract
- Background: The prognostic relevance of blood markers in cerebral stroke is still a matter of controversial debate.<br />Patients and Methods: In sera of 63 patients, nucleosomes, neuronspecific enolase (NSE), S100 protein, and C-reactive protein (CRP) were determined daily during the first week after cerebral stroke. Infarction volume was quantified by CT or MRI and the clinical status by Barthel Index (BI) at admission, discharge, and after 12 months (prognosis). All markers were evaluated by univariate and multivariate analysis on their prognostic relevance.<br />Results: During observation time (12 months), three patients died and 33 reached complete recovery. Infarction volume, nucleosomes, NSE, S100, and CRP correlated significantly with clinical status at admission. The same markers except CRP and initial BI correlated with recovery after 12 months. Almost all patients with initial BI double dagger 50 reached complete recovery. In patients with initially severe defects (BI < 50), nucleosomes and S100, both at day 3, were found to be prognostically relevant. At 100%-specificity for non-recovery, only nucleosomes maintained their prognostic power (sensitivity 52.6%; p = 0.014), whereas S100 did not (sensitivity 16.7%; p = 0.25). In multivariate analysis, nucleosomes and BI at admission showed independent prognostic relevance (p = 0.039).<br />Conclusion: Circulating nucleosomes and clinical scores provide independent prognostic information concerning the later outcome in patients with initially severe defects after stroke.
- Subjects :
- Adult
Aged
Aged, 80 and over
Biomarkers metabolism
C-Reactive Protein metabolism
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging methods
Male
Middle Aged
Phosphopyruvate Hydratase metabolism
Prognosis
S100 Proteins blood
Severity of Illness Index
Statistics, Nonparametric
Stroke pathology
Time Factors
Tomography, X-Ray Computed methods
Nucleosomes metabolism
Stroke blood
Subjects
Details
- Language :
- English
- ISSN :
- 0340-5354
- Volume :
- 254
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of neurology
- Publication Type :
- Academic Journal
- Accession number :
- 17410327
- Full Text :
- https://doi.org/10.1007/s00415-006-0407-5