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Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications

BACKGROUND: Acute decompensated heart failure (ADHF) and respiratory tract infections (RTIs) are potentially life‐threatening complications in patients experiencing stroke during hospitalization. We aimed to test whether blood biomarker panels might predict these complications early after admission....

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Autores principales: Faura, Júlia, Bustamante, Alejandro, Reverté, Silvia, García‐Berrocoso, Teresa, Millán, Mónica, Castellanos, Mar, Lara‐Rodríguez, Blanca, Zaragoza, Josep, Ventura, Oriol, Hernández‐Pérez, María, van Eendenburg, Cecile, Cardona, Pere, López‐Cancio, Elena, Cánovas, David, Serena, Joaquín, Rubiera, Marta, Dávalos, Antoni, Montaner, Joan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174272/
https://www.ncbi.nlm.nih.gov/pubmed/33634708
http://dx.doi.org/10.1161/JAHA.120.018946
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author Faura, Júlia
Bustamante, Alejandro
Reverté, Silvia
García‐Berrocoso, Teresa
Millán, Mónica
Castellanos, Mar
Lara‐Rodríguez, Blanca
Zaragoza, Josep
Ventura, Oriol
Hernández‐Pérez, María
van Eendenburg, Cecile
Cardona, Pere
López‐Cancio, Elena
Cánovas, David
Serena, Joaquín
Rubiera, Marta
Dávalos, Antoni
Montaner, Joan
author_facet Faura, Júlia
Bustamante, Alejandro
Reverté, Silvia
García‐Berrocoso, Teresa
Millán, Mónica
Castellanos, Mar
Lara‐Rodríguez, Blanca
Zaragoza, Josep
Ventura, Oriol
Hernández‐Pérez, María
van Eendenburg, Cecile
Cardona, Pere
López‐Cancio, Elena
Cánovas, David
Serena, Joaquín
Rubiera, Marta
Dávalos, Antoni
Montaner, Joan
author_sort Faura, Júlia
collection PubMed
description BACKGROUND: Acute decompensated heart failure (ADHF) and respiratory tract infections (RTIs) are potentially life‐threatening complications in patients experiencing stroke during hospitalization. We aimed to test whether blood biomarker panels might predict these complications early after admission. METHODS AND RESULTS: Nine hundred thirty‐eight patients experiencing ischemic stroke were prospectively recruited in the Stroke‐Chip study. Post‐stroke complications during hospitalization were retrospectively evaluated. Blood samples were drawn within 6 hours after stroke onset, and 14 biomarkers were analyzed by immunoassays. Biomarker values were normalized using log‐transformation and Z score. PanelomiX algorithm was used to select panels with the best accuracy for predicting ADHF and RTI. Logistic regression models were constructed with the clinical variables and the biomarker panels. The additional predictive value of the panels compared with the clinical model alone was evaluated by receiver operating characteristic curves. An internal validation through a 10‐fold cross‐validation with 3 repeats was performed. ADHF and RTI occurred in 19 (2%) and 86 (9.1%) cases, respectively. Three‐biomarker panels were developed as predictors: vascular adhesion protein‐1 >5.67, NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) >4.98 and d‐dimer >5.38 (sensitivity, 89.5%; specificity, 71.7%) for ADHF; and interleukin‐6 >3.97, von Willebrand factor >3.67, and d‐dimer >4.58 (sensitivity, 82.6%; specificity, 59.8%) for RTI. Both panels independently predicted stroke complications (panel for ADHF: odds ratio [OR] [95% CI], 10.1 [3–52.2]; panel for RTI: OR, 3.73 [1.95–7.14]) after adjustment by clinical confounders. The addition of the panel to clinical predictors significantly improved areas under the curve of the receiver operating characteristic curves in both cases. CONCLUSIONS: Blood biomarkers could be useful for the early prediction of ADHF and RTI. Future studies should assess the usefulness of these panels in front of patients experiencing stroke with respiratory symptoms such as dyspnea.
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spelling pubmed-81742722021-06-11 Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications Faura, Júlia Bustamante, Alejandro Reverté, Silvia García‐Berrocoso, Teresa Millán, Mónica Castellanos, Mar Lara‐Rodríguez, Blanca Zaragoza, Josep Ventura, Oriol Hernández‐Pérez, María van Eendenburg, Cecile Cardona, Pere López‐Cancio, Elena Cánovas, David Serena, Joaquín Rubiera, Marta Dávalos, Antoni Montaner, Joan J Am Heart Assoc Original Research BACKGROUND: Acute decompensated heart failure (ADHF) and respiratory tract infections (RTIs) are potentially life‐threatening complications in patients experiencing stroke during hospitalization. We aimed to test whether blood biomarker panels might predict these complications early after admission. METHODS AND RESULTS: Nine hundred thirty‐eight patients experiencing ischemic stroke were prospectively recruited in the Stroke‐Chip study. Post‐stroke complications during hospitalization were retrospectively evaluated. Blood samples were drawn within 6 hours after stroke onset, and 14 biomarkers were analyzed by immunoassays. Biomarker values were normalized using log‐transformation and Z score. PanelomiX algorithm was used to select panels with the best accuracy for predicting ADHF and RTI. Logistic regression models were constructed with the clinical variables and the biomarker panels. The additional predictive value of the panels compared with the clinical model alone was evaluated by receiver operating characteristic curves. An internal validation through a 10‐fold cross‐validation with 3 repeats was performed. ADHF and RTI occurred in 19 (2%) and 86 (9.1%) cases, respectively. Three‐biomarker panels were developed as predictors: vascular adhesion protein‐1 >5.67, NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) >4.98 and d‐dimer >5.38 (sensitivity, 89.5%; specificity, 71.7%) for ADHF; and interleukin‐6 >3.97, von Willebrand factor >3.67, and d‐dimer >4.58 (sensitivity, 82.6%; specificity, 59.8%) for RTI. Both panels independently predicted stroke complications (panel for ADHF: odds ratio [OR] [95% CI], 10.1 [3–52.2]; panel for RTI: OR, 3.73 [1.95–7.14]) after adjustment by clinical confounders. The addition of the panel to clinical predictors significantly improved areas under the curve of the receiver operating characteristic curves in both cases. CONCLUSIONS: Blood biomarkers could be useful for the early prediction of ADHF and RTI. Future studies should assess the usefulness of these panels in front of patients experiencing stroke with respiratory symptoms such as dyspnea. John Wiley and Sons Inc. 2021-02-26 /pmc/articles/PMC8174272/ /pubmed/33634708 http://dx.doi.org/10.1161/JAHA.120.018946 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Faura, Júlia
Bustamante, Alejandro
Reverté, Silvia
García‐Berrocoso, Teresa
Millán, Mónica
Castellanos, Mar
Lara‐Rodríguez, Blanca
Zaragoza, Josep
Ventura, Oriol
Hernández‐Pérez, María
van Eendenburg, Cecile
Cardona, Pere
López‐Cancio, Elena
Cánovas, David
Serena, Joaquín
Rubiera, Marta
Dávalos, Antoni
Montaner, Joan
Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications
title Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications
title_full Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications
title_fullStr Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications
title_full_unstemmed Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications
title_short Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications
title_sort blood biomarker panels for the early prediction of stroke‐associated complications
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174272/
https://www.ncbi.nlm.nih.gov/pubmed/33634708
http://dx.doi.org/10.1161/JAHA.120.018946
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