Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis

Hanna Pawluk,1 Grzegorz Grześk,2 Renata Kołodziejska,1 Mariusz Kozakiewicz,3 Alina Woźniak,1 Elżbieta Grzechowiak,4 Maciej Szumny,4 Piotr Sobolewski,5 Leszek Bieniaszewski,6 Grzegorz Kozera6 1Department of Medical Biology and Biochemistry, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolau...

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Autores principales: Pawluk H, Grześk G, Kołodziejska R, Kozakiewicz M, Woźniak A, Grzechowiak E, Szumny M, Sobolewski P, Bieniaszewski L, Kozera G
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Lenguaje:EN
Publicado: Dove Medical Press 2020
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Acceso en línea:https://doaj.org/article/f45ad77481374bef9b8edea1d7e295c0
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id oai:doaj.org-article:f45ad77481374bef9b8edea1d7e295c0
record_format dspace
institution DOAJ
collection DOAJ
language EN
topic inflammatory markers
ischemic stroke
thrombolysis
old age diseases
Geriatrics
RC952-954.6
spellingShingle inflammatory markers
ischemic stroke
thrombolysis
old age diseases
Geriatrics
RC952-954.6
Pawluk H
Grześk G
Kołodziejska R
Kozakiewicz M
Woźniak A
Grzechowiak E
Szumny M
Sobolewski P
Bieniaszewski L
Kozera G
Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis
description Hanna Pawluk,1 Grzegorz Grześk,2 Renata Kołodziejska,1 Mariusz Kozakiewicz,3 Alina Woźniak,1 Elżbieta Grzechowiak,4 Maciej Szumny,4 Piotr Sobolewski,5 Leszek Bieniaszewski,6 Grzegorz Kozera6 1Department of Medical Biology and Biochemistry, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 2Department of Cardiology and Clinical Pharmacology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 3Department of Geriatrics, Division of Biochemistry and Biogerontology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 4Department of Neurology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 5Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Jan Kochanowski University, Kielce, Poland; 6Medical Stimulation Center, Medical University of Gdańsk, Gdańsk, PolandCorrespondence: Hanna Pawluk Department of Medical Biology and Biochemistry, Faculty of MedicineCollegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Karłowicza 24, Bydgoszcz 85– 092, PolandTel +48 52 585 37 55Email hannapawluk1@wp.plPurpose: We evaluated the relationship between pretreatment IL-6 and hsCRP levels, symptom severity and functional outcome of patients with acute ischemic stroke (AIS) treated with IV-thrombolysis.Patients and Methods: IL-6 and hsCRP samples were obtained from 83 consecutively treated Caucasian patients with AIS prior to initiation of IV-thrombolysis. Severity of stroke symptoms was assessed using the National Institutes of Health Stroke Scale (NIHSS), whereas functional outcome was assessed with modified Rankin Scale (mRS). The commercially available sets of enzymatic immune tests were used to estimate the concentrations of inflammatory markers in serum.Results: Medians of IL-6 serum concentrations prior to IV-thrombolysis were lower in patients with favorable (mRS 0– 2 pts) functional outcome than in those with unfavorable (mRS 3– 6 pts) functional outcome, both at hospital dismission (5.92: 2.30– 7.71 vs 9.46: 3.79– 17.29 pg/mL; p< 0.01) and on the ninetieth day from stroke onset (5.87: 2.30– 10.58 vs 10.9: 5.94– 17.28 pg/mL; p< 0.01). There were no existing differences regarding hsCRP levels between groups (2.49: 0.11– 9.82 vs 4.44: 0.32– 9.87 mg/dL; p=0.30 and 2.57: 0.11– 2.57 vs 2.83: 0.32– 9.32 mg/dL; p=0.75, respectively). Patients with lacunar strokes were characterized by lower median of IL-6 (5.96: 2.87– 13.0% vs 7.29: 2.30– 17.28; p=< 0.02) and hsCRP (2.25: 0.11– 9.82 vs 4.84: 0.35– 9.87; p=0.01) than those with nonlacunar infarctions. Multivariate analysis showed an impact of IL-6 on mRS measured on hospital dismission and after three months, regardless of their initial NIHSS, presence of hemorrhagic transformation and type 2 diabetes. No impact of hsCRP, lacunar etiology and patients’ age on functional outcome existed.Conclusion: Regardless of the stroke etiology, pretreatment of IL-6, but not of hsCRP levels, may help to predict functional outcome after IV-thrombolysis independently of symptom severity and stroke complications.Keywords: inflammatory markers, ischemic stroke, thrombolysis, old age diseases
format article
author Pawluk H
Grześk G
Kołodziejska R
Kozakiewicz M
Woźniak A
Grzechowiak E
Szumny M
Sobolewski P
Bieniaszewski L
Kozera G
author_facet Pawluk H
Grześk G
Kołodziejska R
Kozakiewicz M
Woźniak A
Grzechowiak E
Szumny M
Sobolewski P
Bieniaszewski L
Kozera G
author_sort Pawluk H
title Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis
title_short Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis
title_full Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis
title_fullStr Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis
title_full_unstemmed Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis
title_sort effect of il-6 and hscrp serum levels on functional prognosis in stroke patients undergoing iv-thrombolysis: retrospective analysis
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/f45ad77481374bef9b8edea1d7e295c0
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spelling oai:doaj.org-article:f45ad77481374bef9b8edea1d7e295c02021-12-02T09:26:55ZEffect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis1178-1998https://doaj.org/article/f45ad77481374bef9b8edea1d7e295c02020-08-01T00:00:00Zhttps://www.dovepress.com/effect-of-il-6-and-hscrp-serum-levels-on-functional-prognosis-in-strok-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Hanna Pawluk,1 Grzegorz Grześk,2 Renata Kołodziejska,1 Mariusz Kozakiewicz,3 Alina Woźniak,1 Elżbieta Grzechowiak,4 Maciej Szumny,4 Piotr Sobolewski,5 Leszek Bieniaszewski,6 Grzegorz Kozera6 1Department of Medical Biology and Biochemistry, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 2Department of Cardiology and Clinical Pharmacology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 3Department of Geriatrics, Division of Biochemistry and Biogerontology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 4Department of Neurology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland; 5Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Jan Kochanowski University, Kielce, Poland; 6Medical Stimulation Center, Medical University of Gdańsk, Gdańsk, PolandCorrespondence: Hanna Pawluk Department of Medical Biology and Biochemistry, Faculty of MedicineCollegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Karłowicza 24, Bydgoszcz 85– 092, PolandTel +48 52 585 37 55Email hannapawluk1@wp.plPurpose: We evaluated the relationship between pretreatment IL-6 and hsCRP levels, symptom severity and functional outcome of patients with acute ischemic stroke (AIS) treated with IV-thrombolysis.Patients and Methods: IL-6 and hsCRP samples were obtained from 83 consecutively treated Caucasian patients with AIS prior to initiation of IV-thrombolysis. Severity of stroke symptoms was assessed using the National Institutes of Health Stroke Scale (NIHSS), whereas functional outcome was assessed with modified Rankin Scale (mRS). The commercially available sets of enzymatic immune tests were used to estimate the concentrations of inflammatory markers in serum.Results: Medians of IL-6 serum concentrations prior to IV-thrombolysis were lower in patients with favorable (mRS 0– 2 pts) functional outcome than in those with unfavorable (mRS 3– 6 pts) functional outcome, both at hospital dismission (5.92: 2.30– 7.71 vs 9.46: 3.79– 17.29 pg/mL; p< 0.01) and on the ninetieth day from stroke onset (5.87: 2.30– 10.58 vs 10.9: 5.94– 17.28 pg/mL; p< 0.01). There were no existing differences regarding hsCRP levels between groups (2.49: 0.11– 9.82 vs 4.44: 0.32– 9.87 mg/dL; p=0.30 and 2.57: 0.11– 2.57 vs 2.83: 0.32– 9.32 mg/dL; p=0.75, respectively). Patients with lacunar strokes were characterized by lower median of IL-6 (5.96: 2.87– 13.0% vs 7.29: 2.30– 17.28; p=< 0.02) and hsCRP (2.25: 0.11– 9.82 vs 4.84: 0.35– 9.87; p=0.01) than those with nonlacunar infarctions. Multivariate analysis showed an impact of IL-6 on mRS measured on hospital dismission and after three months, regardless of their initial NIHSS, presence of hemorrhagic transformation and type 2 diabetes. No impact of hsCRP, lacunar etiology and patients’ age on functional outcome existed.Conclusion: Regardless of the stroke etiology, pretreatment of IL-6, but not of hsCRP levels, may help to predict functional outcome after IV-thrombolysis independently of symptom severity and stroke complications.Keywords: inflammatory markers, ischemic stroke, thrombolysis, old age diseasesPawluk HGrześk GKołodziejska RKozakiewicz MWoźniak AGrzechowiak ESzumny MSobolewski PBieniaszewski LKozera GDove Medical Pressarticleinflammatory markersischemic strokethrombolysisold age diseasesGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 1295-1303 (2020)