Inflammatory and metalloproteinases profiles predict three-month poor outcomes in ischemic stroke treated with thrombolysis

Anna Maria Gori, Betti Giusti, Benedetta Piccardi, Patrizia Nencini, Vanessa Palumbo, Mascia Nesi, Antonia Nucera, Giovanni Pracucci, Paolina Tonelli, Eleonora Innocenti, Alice Sereni, Elena Sticchi, Danilo Toni, Paolo Bovi, Mario Guidotti, Maria Rosaria Tola, Domenico Consoli, Giuseppe Micieli, Rossana Tassi, Giovanni Orlandi & 7 others Maria Sessa, Francesco Perini, Maria Luisa Delodovici, Maria Luisa Zedde, Francesca Massaro, Rosanna Abbate, Domenico Inzitari

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Inflammatory mediators and metalloproteinases are altered in acute ischemic stroke (AIS) and play a detrimental effect on clinical severity and hemorrhagic transformation of the ischemic brain lesion. Using data from the Italian multicenter observational MAGIC (MArker bioloGici nell'Ictus Cerebrale) Study, we evaluated the effect of inflammatory and metalloproteinases profiles on three-month functional outcome, hemorrhagic transformation and mortality in 327 patients with AIS treated with intravenous thrombolys in according to SITS-MOST (Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy) criteria. Circulating biomarkers were assessed at baseline and 24 h after thrombolysis. Adjusting for age, sex, baseline glycemia and National Institute of Health Stroke Scale, history of atrial fibrillation or congestive heart failure, and of inflammatory diseases or infections, baseline alpha-2macroglobulin (A2M), baseline serum amyloid protein (SAP) and pre-post tissue-plasminogen activator (tPA) variations (Δ) of metalloproteinase 9, remained significantly and independently associated with three-month death [OR (95% CI):A2M:2.99 (1.19-7.53); SAP:5.46 (1.64-18.74); Δmetalloproteinase 9:1.60 (1.12-2.27)]. The addition of baseline A2M and Δmetalloproteinase 9 or baseline SAP and Δmetalloproteinase 9 (model-2 or model-3) to clinical variables (model-1) significantly improved the area under curve for prediction of death [model-2 with A2M: p = 0.0205; model-3 with SAP: p = 0.001]. In conclusion, among AIS patients treated with thrombolysis, circulating A2M, SAP and Δmetalloproteinase 9 are independent markers of poor outcome. These results may prompt controlled clinical research about agents antagonizing their effect.

Original languageEnglish
Pages (from-to)3253-3261
Number of pages9
JournalJournal of Cerebral Blood Flow and Metabolism
Volume37
Issue number9
DOIs
Publication statusPublished - Sep 2017

Fingerprint

Metalloproteases
Amyloidogenic Proteins
Stroke
Blood Proteins
National Institutes of Health (U.S.)
Tissue Plasminogen Activator
Atrial Fibrillation
Area Under Curve
Heart Failure
Biomarkers
Mortality
Brain
Infection
Research

Keywords

  • Aged
  • Biomarkers
  • Cytokines
  • Female
  • Humans
  • Logistic Models
  • Male
  • Metalloproteases
  • Multivariate Analysis
  • Predictive Value of Tests
  • ROC Curve
  • Stroke
  • Thrombolytic Therapy
  • Time Factors
  • Treatment Outcome
  • Journal Article

Cite this

Inflammatory and metalloproteinases profiles predict three-month poor outcomes in ischemic stroke treated with thrombolysis. / Gori, Anna Maria; Giusti, Betti; Piccardi, Benedetta; Nencini, Patrizia; Palumbo, Vanessa; Nesi, Mascia; Nucera, Antonia; Pracucci, Giovanni; Tonelli, Paolina; Innocenti, Eleonora; Sereni, Alice; Sticchi, Elena; Toni, Danilo; Bovi, Paolo; Guidotti, Mario; Tola, Maria Rosaria; Consoli, Domenico; Micieli, Giuseppe; Tassi, Rossana; Orlandi, Giovanni; Sessa, Maria; Perini, Francesco; Delodovici, Maria Luisa; Zedde, Maria Luisa; Massaro, Francesca; Abbate, Rosanna; Inzitari, Domenico.

In: Journal of Cerebral Blood Flow and Metabolism, Vol. 37, No. 9, 09.2017, p. 3253-3261.

Research output: Contribution to journalArticle

Gori, AM, Giusti, B, Piccardi, B, Nencini, P, Palumbo, V, Nesi, M, Nucera, A, Pracucci, G, Tonelli, P, Innocenti, E, Sereni, A, Sticchi, E, Toni, D, Bovi, P, Guidotti, M, Tola, MR, Consoli, D, Micieli, G, Tassi, R, Orlandi, G, Sessa, M, Perini, F, Delodovici, ML, Zedde, ML, Massaro, F, Abbate, R & Inzitari, D 2017, 'Inflammatory and metalloproteinases profiles predict three-month poor outcomes in ischemic stroke treated with thrombolysis', Journal of Cerebral Blood Flow and Metabolism, vol. 37, no. 9, pp. 3253-3261. https://doi.org/10.1177/0271678X17695572
Gori, Anna Maria ; Giusti, Betti ; Piccardi, Benedetta ; Nencini, Patrizia ; Palumbo, Vanessa ; Nesi, Mascia ; Nucera, Antonia ; Pracucci, Giovanni ; Tonelli, Paolina ; Innocenti, Eleonora ; Sereni, Alice ; Sticchi, Elena ; Toni, Danilo ; Bovi, Paolo ; Guidotti, Mario ; Tola, Maria Rosaria ; Consoli, Domenico ; Micieli, Giuseppe ; Tassi, Rossana ; Orlandi, Giovanni ; Sessa, Maria ; Perini, Francesco ; Delodovici, Maria Luisa ; Zedde, Maria Luisa ; Massaro, Francesca ; Abbate, Rosanna ; Inzitari, Domenico. / Inflammatory and metalloproteinases profiles predict three-month poor outcomes in ischemic stroke treated with thrombolysis. In: Journal of Cerebral Blood Flow and Metabolism. 2017 ; Vol. 37, No. 9. pp. 3253-3261.
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T1 - Inflammatory and metalloproteinases profiles predict three-month poor outcomes in ischemic stroke treated with thrombolysis

AU - Gori, Anna Maria

AU - Giusti, Betti

AU - Piccardi, Benedetta

AU - Nencini, Patrizia

AU - Palumbo, Vanessa

AU - Nesi, Mascia

AU - Nucera, Antonia

AU - Pracucci, Giovanni

AU - Tonelli, Paolina

AU - Innocenti, Eleonora

AU - Sereni, Alice

AU - Sticchi, Elena

AU - Toni, Danilo

AU - Bovi, Paolo

AU - Guidotti, Mario

AU - Tola, Maria Rosaria

AU - Consoli, Domenico

AU - Micieli, Giuseppe

AU - Tassi, Rossana

AU - Orlandi, Giovanni

AU - Sessa, Maria

AU - Perini, Francesco

AU - Delodovici, Maria Luisa

AU - Zedde, Maria Luisa

AU - Massaro, Francesca

AU - Abbate, Rosanna

AU - Inzitari, Domenico

PY - 2017/9

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N2 - Inflammatory mediators and metalloproteinases are altered in acute ischemic stroke (AIS) and play a detrimental effect on clinical severity and hemorrhagic transformation of the ischemic brain lesion. Using data from the Italian multicenter observational MAGIC (MArker bioloGici nell'Ictus Cerebrale) Study, we evaluated the effect of inflammatory and metalloproteinases profiles on three-month functional outcome, hemorrhagic transformation and mortality in 327 patients with AIS treated with intravenous thrombolys in according to SITS-MOST (Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy) criteria. Circulating biomarkers were assessed at baseline and 24 h after thrombolysis. Adjusting for age, sex, baseline glycemia and National Institute of Health Stroke Scale, history of atrial fibrillation or congestive heart failure, and of inflammatory diseases or infections, baseline alpha-2macroglobulin (A2M), baseline serum amyloid protein (SAP) and pre-post tissue-plasminogen activator (tPA) variations (Δ) of metalloproteinase 9, remained significantly and independently associated with three-month death [OR (95% CI):A2M:2.99 (1.19-7.53); SAP:5.46 (1.64-18.74); Δmetalloproteinase 9:1.60 (1.12-2.27)]. The addition of baseline A2M and Δmetalloproteinase 9 or baseline SAP and Δmetalloproteinase 9 (model-2 or model-3) to clinical variables (model-1) significantly improved the area under curve for prediction of death [model-2 with A2M: p = 0.0205; model-3 with SAP: p = 0.001]. In conclusion, among AIS patients treated with thrombolysis, circulating A2M, SAP and Δmetalloproteinase 9 are independent markers of poor outcome. These results may prompt controlled clinical research about agents antagonizing their effect.

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KW - Aged

KW - Biomarkers

KW - Cytokines

KW - Female

KW - Humans

KW - Logistic Models

KW - Male

KW - Metalloproteases

KW - Multivariate Analysis

KW - Predictive Value of Tests

KW - ROC Curve

KW - Stroke

KW - Thrombolytic Therapy

KW - Time Factors

KW - Treatment Outcome

KW - Journal Article

U2 - 10.1177/0271678X17695572

DO - 10.1177/0271678X17695572

M3 - Article

VL - 37

SP - 3253

EP - 3261

JO - Journal of Cerebral Blood Flow and Metabolism

JF - Journal of Cerebral Blood Flow and Metabolism

SN - 0271-678X

IS - 9

ER -