Persistent inflammatory response in stroke survivors

N. B. Beamer, Bruce M. Coull, W. M. Clark, D. P. Briley, M. Wynn, G. Sexton

Research output: Contribution to journalArticle

109 Scopus citations

Abstract

Objective: Goals were to determine how long acute-phase markers remain elevated after ischemic stroke and how marker levels relate to stroke risk factors, stroke mechanism, and subsequent vascular events. Methods: Fibrinogen (FIB), C-reactive protein (CRP), leukocytes (WBC), neutrophils (PMN), interleukin-6, and interleukin-1 receptor antagonist were measured at stroke onset and at 6 weeks, 6 months, and 1 year after enrollment, or until a vascular event occurred in 136 acute ischemic stroke patients, 76 patients with comparable risk factors for stroke, and 48 age-balanced healthy subjects. Results: Multivariate logistic analysis showed that prior stroke and FIB level predicted new events in stroke patients (p < 0.04 for both), whereas congestive heart failure (p < 0.02) and creatinine level (p < 0.006) were predictive in at-risk patients. After controlling for infection, FIB, CRP, and PMN levels at baseline were higher in at-risk but not in stroke patients with recurrent events (p < 0.05 for all). At 1 year, FIB levels remained elevated in event-free stroke survivors compared with levels in the risk and control groups (p < 0.001 for both). FIB also remained higher in stroke survivors who had atheroembolism (AE) compared with non-AE stroke survivors (381 ± 72 versus 342 ± 78 mg/dL, p < 0.02). Peripheral vascular disease was an independent predictor (p < 0.0001) of longitudinal FIB in stroke survivors. Of note, both WBC and PMN levels were chronically elevated in patients with stroke risk factors and in stroke survivors (p < 0.0001 for both) compared with healthy elderly subjects. Conclusions: Most acute-phase markers decline gradually after stroke, but FIB remains significantly elevated and is associated with increased risk for recurrent vascular events.

Original languageEnglish (US)
Pages (from-to)1722-1728
Number of pages7
JournalNeurology
Volume50
Issue number6
DOIs
StatePublished - Jun 1998

ASJC Scopus subject areas

  • Clinical Neurology

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    Beamer, N. B., Coull, B. M., Clark, W. M., Briley, D. P., Wynn, M., & Sexton, G. (1998). Persistent inflammatory response in stroke survivors. Neurology, 50(6), 1722-1728. https://doi.org/10.1212/WNL.50.6.1722