Background: acute ischemic stroke (AIS) remains the third cause of death and disability, and acute phase responses, both increasing international normalized ratio (INR) and activated partial thromboplastin time (APTT) are associated with worse outcome. Erythrocyte sedimentation rate (ESR) serves as severity marker, and non-fasting triglycerides (TG) indicates remnants of chylomicrons and very low density lipoproteins potentially pro-inflammatory. Aims: to design predictive economic panel evaluating AIS. Patients and methods: 100(AIS) patients were included, clinically evaluated by Scandinavian Stroke Scale (SSS) and Modified Rankin Score (MRS), subjected to complete blood count (CBC) on Cell-Dyne3700, manual ESR, INR and APTT on SYSMEX-CA1500, serum uric acid (SUA), serum albumin and non-fasting (TG) on Beckman Coulter AU480. Statistical analysis: STATA intercooled version 9.2. Results: odd ratio (OR), confidence interval (CI) of (MRS) in correlation to WBCs count in quartile (Q)3, 4 (OR 8.14, CI 2.29 - 8.90, significant P = 0.01; and OD13.5, CI 3.39 - 53.68, high significant P = 0.001 respectively), to APTT in Q3 (OD 4.15, CI 1.09 - 15.82, P = 0.04), SUA in Q3 (OD 0.19, CI 0.05 - 0.68, P = 0.01), TG in Q3,4 (OD 0.24 CI 0.06 - 0.88, P = 0.03; and OD 0.09, CI 0.02 - 0.34 P = 0.001 respectively) and serum albumin in Q3(OD 0.13, CI 0.04 - 0.51, P = 0.003), insignificant correlations to ESR, INR and platelets. Conclusion: according to (MRS), the economic predictive panel should be included WBCs, APTT, SUA, and non-fasting TG with serum albumin as prognostic tool evaluating functional disability in AIS.
Peacock, W.F. (2016) Where Are Stroke Markers? 2016 by the American Association for Clinical Chemistry, Clinical Chemistry, Vol. 63, Issue 1. https://doi.org/10.1373/clinchem.2016.255091
Jickling, G.C. and Sharp, F.R. (2011) Blood Biomarkers of Ischemic Stroke. Neurotherapeutics, 8, 349-360.
Glushakova, O.Y., Glushakova, A.V., Miller, E.R., Valadka, A.B. and Hayes, R.L. (2016) Biomarkers for Acute Diagnosis and Management of Stroke in Neurointensive Care Units. Brain Circulation, 2, 28-47.
Barber, M., Fail, M., Shields, M., Stott, D.J. and Langhorne, P. (2004) Validity and Reliability of Estimating the Scandinavian Stroke Scale Score from Medical Records. Cerebrovascular Diseases, 17, 224-227. https://doi.org/10.1159/000075795
Jickling, G.C. and Sharp, F.R. (2015) Biomarkers Panels in Ischemic Stroke. Stroke, 46, 915-920.
Kim, S.J., Moon, J. and Bang, O.Y. (2013) Biomarkers for Stroke. Journal of Stroke, 15, 27-37. https://doi.org/10.5853/jos.2013.15.1.27
Pregl, V. (2016) Leucocyte Count Indicates Carotid Plaque Instability in Stroke Patients. Clinical and Experimental Pharmacology and Physiology, 73, 515-525.
Tsai, N.W., Chang, W.N., Shaw, C.F., Jan, C.R. and Lu, C.H. (2010) Leucocyte Apoptosis in Patients with Acute Ischemic Stroke. Clinical and Experimental Pharmacology and Physiology, 37, 884-888. https://doi.org/10.1111/j.1440-1681.2010.05398.x
Xie, D., Hu, D., Zhang, Q., Sun, Y., Li, J. and Zhang, Y. (2016) Increased High Sensitive CRP, ESR and Lactic Acid in Stroke Patients with Internal Carotid Artery Occlusion. Archives of Medical Science, 12, 546-551. https://doi.org/10.5114/aoms.2014.47879
Singh, A.S., Atam, V., Yathish, B.E., Das, L. and Koonwar, S. (2014) Role of Erythrocyte Sedimentation Rate in Ischemic Stroke as an Inflammatory Marker of Carotid Atherosclerosis. Journal of Neurosciences in Rural Practice, 5, 40-45. https://doi.org/10.4103/0976-3147.127870
Kang, D.W., Yoo, S.H., Chun, S., Kwon, K.Y., Kwon, S.U., Koh, J.Y. and Kim, J.S. (2009) Inflammatory and Hemostatic Biomarkers Associated with Early Recurrent Ischemic Lesions in Acute Ischemic Stroke. Stroke, 40, 1653-1658. https://doi.org/10.1161/STROKEAHA.108.539429
Greuters, S., Van den Berg, A., Franschman, G., Viersen, V.A. and Beishuzen, A. (2011) Peerdeman SM and Boer C. Acute and Delayed Mild Coagulopathy Are Related to Outcome in Patients with Isolated Traumatic Brain Injury. Critical Care, 15, R2.
Nomura, E., Ohshita, T., Imamura, E., Wakabayashi, S., Hosomi, N. and Matsumoto, M. (2015) Early Administration of Non-Vitamin K Antagonist Oral Anticoagulants for Acute Ischemic Stroke Patients with Atrial Fibrillation in Comparison with Warfarin Mostly Combined with Heparin. Circulation Journal, 79, 862-866.
Yamamoto, R., Nakae, Y., Tanaka, F. and Johkura, K. (2016) D-Dimer versus International Normalized Ratio of Prothrombin Time in Ischemic Stroke Patients Treated with Sufficient Warfarin. Journal of Stroke and Cerebrovascular Diseases, 25, 1781-1785.
Ertekin, B., Kocak, S., Define Dundar, Z., Girisgin, S., Cander, B., Gul, M., Doseyici, S., Mehmetoglu, I. and Kemal Sahin, T. (2013) Diagnostic Value of Ischemic Modified Albumin in Acute Coronary Syndrome and Acute Ischemic Stroke. Pakistan Journal of Medical Sciences, 29, 1003-1007. https://doi.org/10.12669/pjms.294.3176
Mehta, M.D., Marwah, S.A., Ghosh, S., Salah, H.N., Trivedi, A.P. and Haridas, N.A. (2015) Synergistic Role of Ischemic Modified Albumin and High Sensitivity Troponin in the Early Diagnosis of Acute Coronary Syndrome. Journal of Family Medicine and Primary Care, 4, 570-575.
Liu, X., Liu, M., Chen, M., Ge, Q.M. and Pan, S.M. (2015) Serum Uric Acid Is Neuro-Protective in Chines Patients with Acute Ischemic Stroke Treated with Intravenous Recombinant Tissue Plasminogen Activator. Journal of Stroke and Cerebrovascular Diseases, 24, 1080-1086.
Zhang, X., Huang, Z.C., Lu, T.S., You, S.J., Cao, Y.J. and Liu, C.F. (2016) Prognostic Significant of Uric Acid Level in Ischemic Stroke Patients. Neurotoxicity Research, 29, 10-20.
Choi, K.H., Park, M.S. and Kim, J.T. (2012) Serum Triglyceride Level Is an Important Predictor of Early Prognosis in Patients with Acute Ischemic Stroke. Journal of the Neurological Sciences, 319, 111-116.
Varbo, A., Nordestgaard, B.G., Tybjaerg-Hansen, A., Schnohr, P., Jensen, G.B. and Benn, M. (2011) Non-Fasting Triglycerides, Cholesterol, and Ischemic Stroke in the General Population. Annals of Neurology, 69, 628-634. https://doi.org/10.1002/ana.22384
Pan, R., Yu, K., Weatherwax, T., Zheng, H., Liu, W. and Liu, K.J. (2017) Blood Occludin Level as Potential Biomarkers for Early Blood Brain Barrier Damage Following Stroke. Science Repots, 7, Article No. 40331.
Lakshmi, A.B., Uma, P., Venkatachalam, C.H. and Nageswar Rao, G.S. (2011) A Simple Slide Test to Assess Erythrocyte Aggregation in Acute ST Elevated Myocardial Infarction and Acute Ischemic Stroke: Its Prognostic Significance. Indian Journal of Pathology and Microbiology, 54, 63-69. https://doi.org/10.4103/0377-4929.77327
Scarborough, P.P., Bhatnagar, V.P., Kaur, L.A.J., Fernandez, L.R., Gray, A., Rayner, M. and Allender, S. (2009) Stroke Statistics. British Heart Foundation and Stroke Association, 44.
Townsend, N., Wickramasinghe, K., Bhatnagar, P., Smolina, K., Nichols, M., Leal, J., Fernandez, L.R. and Rayner, M. (2012) Coronary Heart Disease Statistics. British Heart Foundation and Stroke Association, 57.
Zhou, G., Nie, S. and Dai, L. (2013) Sex Differences in Stroke Case Fatality: A Meta-Analysis. Acta Neurologica Scandinavica, 128, 1. https://doi.org/10.1111/ane.12091
Whiteley, W., Wardlaw, J., Dennis, M., Lowe, G., Rumley, A., Sattar, N., Welsh, P., Green, A., Andrews, M. and Sandercock, P. (2012) The Use of Blood Biomarkers to Predict Poor Outcome after Acute Transient Ischemic Attack or Ischemic Stroke. Stroke, 43, 86-91. https://doi.org/10.1161/STROKEAHA.111.634089
Peng, Y., Wang, D. and Zhang, J. (2011) Relationship between White Blood Cell Count at Admission and Short Term Outcome in Patients with Acute Cerebral Infarction. Clinical & Investigative Medicine, 34, 249. https://doi.org/10.25011/cim.v34i4.15368
Nardi, K., Milia, P. and Eusebi, P. (2011) Admission Leukocytosis in Acute Cerebral Ischemia: Influence on Early Outcome. Journal of Stroke and Cerebrovascular Diseases, 21, 819-824.
Kisialiou, A., Pelone, G., Carrizzo, A., Grillea, G., Trimarco, V. and Marino, M. (2012) Blood Biomarkers Role in Acute Ischemic Stroke Patients: Higher Is Worse or Better?
Zeller, J.A., Lenz, A., Tschoepe, D., Kessler, C. and Eschenfelder, C.C. (2005) Platelet Leukocyte Interaction and Platelet Activation in Acute Stroke with and without Preceding Infection. Arteriosclerosis, Thrombosis, and Vascular Biology, 25, 1519-1523. https://doi.org/10.1161/01.ATV.0000167524.69092.16
Nomura, E., Ohshita, T., Imamura, E., Wakabayashi, S., Kajikawa, H. and Matsumoto, M. (2014) Can Early Effective Anticoagulation Prevent New Lesions on Magnetic Resonance Imaging in Acute Cardioembolic Stroke. Journal of Stroke and Cerebrovascular Diseases, 23, 2099-2104.
Dziedzic, T., Slowik, A., Gryz, E.A. and Szczudlik, A. (2004) Lower Serum Triglyceride Level Is Associated with Increased Stroke Severity. Stroke, 35, e151-e152. https://doi.org/10.1161/01.STR.0000128705.63891.67
Adibhatla, R.M. and Hatcher, J.F. (2008) Altered Lipid Metabolism in Brain Injury and Disorders. Subcellular Biochemistry, 49, 241-268. https://doi.org/10.1007/978-1-4020-8831-5_9
Belayev, L., Liu, Y., Zhao, W., Busto, R. and Ginsberg, M.D. (2001) Human Albumin Therapy of Acute Ischemic Stroke. Marked Neuroprotective Efficacy at Moderate Doses and with a Broad Therapeutic Window. Stroke, 32, 553-560. https://doi.org/10.1161/01.STR.32.2.553
Lu, H.T., Zhao, J.G., Li, M.H. and Li, Y.D. (2012) Application of Albumin Prior to Delayed Thrombolysis Reduces Brain Edema and Blood Brain Barrier Permeability in an Embolic Stroke Model. Brain Research, 1438, 75-84.
Amaro, S., Urra, X., Gomez-Choco, M., Obach, V., Cervera, A., Vargas, M., Torres, F., Rios, J., Planas, A.M. and Chamorro, A. (2011) Uric Acid Levels Are Relevant in Patients with Stroke Treated with Thrombolysis. Stroke, 42, S28-S32. https://doi.org/10.1161/STROKEAHA.110.596528
Hong, J.M., Bang, O.Y., Chung, C.S., Joo, I.S. and Gwag, B.J. (2010) Ovbiagele B: Influence of Recanalization on Uric Acid Patterns in Acute Ischemic Stroke. Cerebrovascular Diseases, 29, 431-439. https://doi.org/10.1159/000289346