Blood markers predict risk for recurrent stroke and mortality

New York People who have just suffered their first ischemic stroke, a blood clot in the brain, often have elevated inflammatory biomarkers in their blood that indicate their likelihood of having another stroke or an increased risk of dying, according to Columbia University Medical Center researchers at NewYork-Presbyterian Hospital. Published in the Oct. 23 Archives of Internal Medicine, results indicate that these inflammatory markers are associated with long-term prognosis after a first stroke, and may help guide clinical care for people who have suffered a first stroke.

A biomarker called lipoprotein-associated phospholipase A2 (Lp-PLA2), which has been FDA-approved to predict the risk of first stroke, was found to be a strong predictor of recurrent stroke risk. Researchers also found that elevated levels of another biomarker called high-sensitivity C-reactive protein (hs-CRP), a test commonly used to predict risk of heart disease, was associated with more severe strokes and an increased risk of mortality.

"A better understanding of biomarkers for stroke risk may lead to the use of prophylactic treatments to reduce risk of people suffering debilitating strokes," said lead author Mitchell S. V. Elkind, M.D., M.S., associate professor of Neurology at Columbia University College of Physicians and Surgeons and neurologist at NewYork-Presbyterian. "For example, statins appear to lower these biomarker levels, so our next step may be to study the clinical benefit of prescribing statins to reduce the risk of stroke in people with elevated biomarkers, and also to treat people who have suffered a stroke so that they do not have another serious event."

The research was conducted by taking blood samples from 467 patients who had just suffered their first ischemic stroke, from the Northern Manhattan Stroke Study, a long-term prospective study among people from the Washington Heights neighborhood in Northern Manhattan and the surrounding area. The ongoing study, which began in 1990, is run by the Neurological Institute of New York at Columbia University Medical Center and NewYork-Presbyterian, located in Washington Heights.

The team of researchers at Columbia and NewYork-Presbyterian also included: Ralph L. Sacco, M.D., M.S.; Wanling Tai, B.S.; Kristen Coates, B.S.; and, Myunghee C. Paik, Ph.D.

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Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, nurses, dentists, and public health professionals at the College of Physicians & Surgeons, the College of Dental Medicine, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. www.cumc.columbia.edu

NewYork-Presbyterian Hospital--based in New York City--is the nation's largest not-for-profit, non-sectarian hospital, with 2,224 beds. It provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth on U.S. News & World Report's guide to "America's Best Hospitals," has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital has academic affiliations with two of the nation's leading medical colleges: Joan and Sanford I. Weill Medical College of Cornell University and Columbia University College of Physicians and Surgeons. www.nyp.org

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