Comparative evaluation of risk factors, outcome and biomarker levels in young and old acute ischemic stroke patients

Abstract

BackgroundStroke is the third leading cause of death and disability worldwide accounting for 400-800 strokes per 100,000 individuals each year.PurposeIn the present study, we compared risk factors, clinical outcome, and prognostic biomarkers NSE, S-100 ßß and ITIH4 levels in young and old acute ischemic stroke (AIS) patients.MethodsWe compared the risk factors and clinical outcomes in young (n = 38) and old (n = 66) AIS patients admitted to tertiary health care centre in Central India. In addition, we also evaluated NSE, S100ββ & ITIH4 levels in admission and discharge samples of young and old AIS patients with different clinical outcome.ResultsHypertension was a major risk factor in 45% of young and 80% of old AIS patients. Hospital outcome was less favorable in young AIS patients with higher dependent rates of 24% as compared to 12% in old AIS patients. Whereas long term outcome at 12 and 18 months after discharge was more favorable in young AIS patients with low dependency rates of 16% and 11% as compared to 41% and 24% in older AIS patients respectively. Similarly, serum NSE, S100ββ and ITIH4 levels showed a distinct pattern of expression at discharge time in AIS patients with improved and dependent outcome in both the age groups.ConclusionYoung males with hypertension and smoking habits are at a high risk of AIS while old AIS patients are at a greater risk of worse long term outcome. Serum levels of NSE and S100ββ are independent predictors of outcome in AIS patients. Similarly, it also suggests that serum ITIH4 levels could be used as a potential biomarker for predicting the outcome in AIS patients.

Association of serum neuron‐specific enolase and bilirubin levels with cerebral dysfunction and prognosis in large‐artery atherosclerotic strokes

“…Therefore, the detection of NSE serum levels could provide a laboratory basis for the clinical diagnosis of brain injuries . Kawle et al found that serum levels of NSE were an independent predictor of the outcome in IS patients . Furthermore, Smith et al showed that increased levels of NSE were correlated with brain infarction size, stroke severity, and overall prognosis …”

Circulating long noncoding RNA ANRIL downregulation correlates with increased risk, higher disease severity and elevated pro‐inflammatory cytokines in patients with acute ischemic stroke

“…Acute ischemic stroke, a major cerebrovascular disease, is caused by vascular occlusion that decreases cerebral blood flow to an area of brain perfused by an occluded artery . Atherosclerosis is the main cause of AIS, and inflammatory responses are involved in endothelial dysfunction and propagation of atherosclerosis, contributing to ischemic brain injuries .…”

“…Stroke is the leading cause of acquired neurological disability and the second leading cause of death worldwide, with incidences ranging from 400 to 800 people per 100 000 every year worldwide . In China, 2.5 million new stroke cases occur each year, and there are 7.5 million stroke survivors; approximately 15%‐30% of stroke survivors are left permanently disabled .…”

“…In China, 2.5 million new stroke cases occur each year, and there are 7.5 million stroke survivors; approximately 15%‐30% of stroke survivors are left permanently disabled . Stoke includes acute ischemic stroke (AIS) and hemorrhagic stroke, with the former being responsible for almost 85% of cases . At present, the diagnosis of AIS primarily relies on laboratory examination and neuroimaging techniques, including computed tomography or magnetic resonance imaging (MRI), digital subtraction angiography (DSA), and transcranial Doppler ultrasound (TCD), among which DSA remains the gold standard for diagnosis of AIS; however, the exorbitant cost and invasiveness are not suitable for all patients .…”

Utility of Chedoke arm hand activity inventory in the Indian population: mixed method research sequential explanatory

“…1 It is seen in all age groups and is increasingly common in younger ages with huge economic costs in management. [2][3][4] It has been estimated that there will be more than 1.67 million stroke survivors in India by 2020. 5,6 One of the most common disabilities in stroke is upper limb dysfunction with eighty-five percent of the survivors reported to experience hemi paresis immediately after stroke, fiftyfive to seventy-five percent continue life with motor deficit which affects daily life and social life.…”