Prognosis
Stroke prognosis presents huge interpersonal variability and entails the interaction between several factors (e.g. age, comorbidities, stroke severity). Most of them are not modifiable but others are derived from the own pathological process (such as brain edema, post-stroke infections,...) or the therapeutic measures (such as post-tPA hemorrhagic transformation,...). Early prediction and management of these complications represents a unique opportunity to improve stroke outcome.
Biomarkers might add information at that level, thus optimizing the admission of patients to specialized stroke units, where more aggressive and specific management of stroke complications can be decided. Moreover biomarkers could help in quick decision-making regarding inclusion in alternative clinical trials or in the need of rehabilitation at discharge.
Here you will find information about biomarkers associated with stroke prognosis.
Prognosis
| Symbol | Description | Associations | Endpoint | Genecards |
|---|---|---|---|---|
| 1N86 | D-dimer | D-dimer is a fibrin degradation product. It is increased in acute phase of ischemic stroke and is associated with a high risk of recurrence and with cardioembolic etiology. It has been also associated with poor outcome and mortality. Similar levels have been determined in both subtypes of stroke during acute phase. | Disability, Exitus |  |
| 778 | Homocysteine | Hyperhomocysteinemia is associated with death after stroke. Its association with long-term disability is not clear.No clear association has been found between homocysteine levels and aetiological classification of ischemic stroke | Exitus, Worsening, Disability | |
| 9085 | Homoarginine | Low homoarginine levels are associated with poor outcome at both short- and long-term, although does not seem to add predictive value to clinical variables. | No | |
| P01185 | NEU2 | Copeptin adds predictive information on functional outcome and mortality at long-term. | Disability, Exitus, Infection, Worsening | |
| P02671 | FIBA | Higher levels of circulating fibrinogen are associated with long-term poor outcome and death after stroke and with increased risk of ischemic stroke, but not provides incremental value over traditional risk factors. The association between fibrinogen levels and aetiological subtypes of ischemic strokes is not concordant in different studies. | Disability, Exitus | |
| P02741 | CRP | Independent of other cardiovascular risk factors, elevated plasma CRP levels significantly predict the risk of future ischemic stroke and TIA in the elderly. In ischemic stroke patients, high CRP circulating levels within 24h from onset are associated with poor long-term functional outcome [2]. No clear association has been found with aetiological classification of ischemic stroke. No diferences at plasma levels between hemorragic and ischemic stroke. | Disability, Edema, Worsening, Exitus, Infection | |
| P02751 | FINC | Several studies has found raised fibronectin levels in stroke patients who develop a hemorrhagic transformation after tPA treatment. | HT | |
| P02768 | ALBU | Baseline Ischemia-Modified Albumin (IMA) blood levels may be a biomarker for early identification of acute stroke, but not to differentiate Ischemic from hemorrhagic stroke patients. On the other hand, serum albumin is decreased in those patients who die following a stroke. No significant association has been found between vWf levels and aetiological subtypes of ischemic stroke. No ignificant difference at plasma level between stroke subtypes. | No | |
| P02792 | FRIL | In stroke, high ferritin levels have been associated with hemorrhagic transformation and outcome. | Exitus | |
| P04271 | S100B | Higher levels of S100B in ischemic stroke patients than healthy controls, showing a trend to be higher in those patients with poor outcome at third month after stroke. Also, high S100B leves have been associated with hemorrhagic transformation and brain edema. No clear association has been found between S100B levels and aetiological classification of ischemic stroke. Higher plasma levels were found in intracerebral hemorrhage than ischemic stroke patients. | HT | |
| P04275 | VWF | Higher circulating levels in stroke patients with functional disability at third month after the event. No significant association has been found between vWf levels and aetiological classification of ischemic stroke | Disability | |
| P05231 | IL6 | IL6 has been studied in stroke patients regarding stroke incidence, recurrence and prognosis and higher levels of IL6 have been associated with all of these endpoints. It has also been proposed as a predictor of infections. No significant association has been found between IL6 levels and aetiological subtypes of ischemic stroke | Disability, Infection, Exitus | |
| P06276 | CHLE | Low cholinesterase activity in stroke patients who will die within 1 year. | No | |
| P06881 | CALCA | Procalcitonin is used in clinical practise as a marker of bacterial infections. In stroke, it has been described as a predictor os stroke-associated infections. | Infection | |
| P09429 | HMGB1 | Higher circulating levels of HMGB1 are associated with poor outcome 1 year after stroke. | Exitus, Disability | |
| P14780 | MMP9 | Associated with BBB disruption. Positively correlated with stroke severity and infart volume within acute phase of ischemic stroke. Raised plasma MMP-9 in stroke patients than mimics. Its relationship with poor outcome is not clear. Similar levels have been determined in both subtypes of stroke during acute phase. | Disability, HT | |
| P16581 | LYAM2 | E-selectin does not show significant differences in ischemic stroke patients comparet to patients with TIA when measured in plasma during the first 12 h after onset but is associated with increased risk of ischemic stroke. No significant association has been found between E-selectine levels and aetiological subtypes of ischemic stroke | Disability | |
| P16860 | ANFB | High circulating levels of BNP/NT-proBNP are associated with poor outcome after stroke, although only minor predictive value is added to clinical information [2]. High BNP levels indicate an embolic origin for stroke patients. Similar levels have been determined in both subtypes of stroke. | Disability, Exitus, Worsening, Other, No | |
| P22303 | ACES | Low cholinesterase activity in stroke patients who will die within 1 year. | No | |
| P26022 | PTX3 | Higher plasma PTX3 levels are associated with mortality after stroke. | Exitus | |
| P45379 | TNNT2 | cTnT is a cardiac marker for acute coronary syndromes. In stroke, cTnt has been associated with poor long-term prognosis and death. | Disability, Exitus | |
| Q13740 | CD166 | Patients who died after ischemic stroke had higher levels of ALCAM/CD166. | Exitus | |
| Q15848 | ADIPO | Higher adiponectin circulating levels are associated with functional disability 3 months after stroke and cardioembolic etiology. Adiponectin is related with increased risk of ischemic stroke and improves net reclassification using multivariable predicting models. | Disability | |
| Q99988 | GDF15 | GDF15 is independently associated to poor long-term outcome after stroke, although it did not improve the prediction over NIHSS. | Disability | |
| SID 53789179 | HDL-Cholesterol | HDL cholesterol levels are used for vascular risk factors management in primary and secondary vascular prevention. It has recently been associated with development of post-stroke infections | No | |