BACKGROUND Ischemic injury triggers inflammatory cascades and changes in the protein synthesis, neurotransmitters and neuro-hormones in the brain parenchyma that may further amplify the tissue damage. The "Triage® Stroke Panel", a biochemical multimarker assay, detects Brain Natriuretic Peptide (BNP), D-Dimers (DD), Matrix-Metalloproteinase-9 (MMP-9), and S100β protein generating a Multimarker index of these values (MMX). The aims of this prospective study in consecutive patients with ischemic or hemorrhagic stroke were to assess: 1) the rate of an increase of biomarkers (BNP, D-dimer, MMP-9 and S-100β) tested with the Triage Stroke Panel; 2) the correlation between the increase of these biomarkers and functional outcome at 4 months; 3) the risk factors for the increase of biomarkers. METHODS The outcome of the study was 120-day mortality and it was compared in patients with Stroke Panel >4 and ≤4. Multiple logistic regression analyses were performed to identify independent predictors for death and for the increase of biomarkers. RESULTS 244 consecutive patients (mean age 73.02 years; 53.7 % males) were included in the study; 210 ischemic strokes and 34 hemorrhagic strokes. 161/244 (66.0 %) had an increase of biomarkers. At 120 days, 85 patients had died (34.8 %). Death was seen in 68/161 patients with an increase of biomarkers (42.2 %) compared with 17/83 patients without (20.5 %). Regression logistic analysis found that a Stroke Panel >4 (OR 3.1; 95 % CI 1.5-6.2, p = 0.002) was associated with mortality. The increase of biomarkers was independently predicted by an increase of PCR on admission (OR 2.9, 95 CI 1.4-6.0, p = 0.003). CONCLUSIONS An increase of biochemical markers such as BNP, D-Dimers, MMP-9, and S100β tested with a Triage Stroke Panel (>4) was correlated with mortality at 120 days from stroke onset.

中文翻译：

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中风生物标志物的预后价值。

背景技术缺血性损伤触发炎性级联，并改变脑实质中蛋白质合成，神经递质和神经激素的变化，这可能进一步放大组织损伤。生化多标记测定“Triage®Stroke Panel”可检测脑利钠肽（BNP），D-二聚体（DD），基质金属蛋白酶9（MMP-9）和S100β蛋白，从而产生这些值的多标记指数（ MMX）。这项连续性缺血性或出血性中风患者的前瞻性研究旨在评估：1）用Triage Stroke Panel测试的生物标志物（BNP，D-二聚体，MMP-9和S-100β）的增加率；2）这些生物标志物的增加与4个月时的功能结局之间的相关性；3）生物标志物增加的危险因素。方法研究的结果是120天的死亡率，并在卒中组> 4和≤4的患者中进行了比较。进行了多个逻辑回归分析，以确定死亡和生物标志物增加的独立预测因子。结果该研究纳入了244例连续患者（平均年龄73.02岁；男性为53.7％）。210例缺血性中风和34例出血性中风。161/244（66.0％）的生物标志物增加。在120天时，有85位患者死亡（34.8％）。在68/161例患者中，有生物标志物的患者死亡（42.2％），而没有生物标志物的17/83例患者（20.5％）。回归逻辑分析发现，卒中组> 4（OR 3.1； 95％CI 1.5-6.2，p = 0.002）与死亡率相关。生物标志物的增加是通过入院时PCR的增加独立预测的（OR 2.9、95 CI 1.4-6.0，p = 0.003）。结论用Triage Stroke Panel（> 4）测试的生化标志物，例如BNP，D-Dimers，MMP-9和S100β的增加与中风发作后120天的死亡率相关。