Details

Autor(en) / Beteiligte

• Honegger, Tim
• Schweizer, Juliane
• Bicvic, Antonela
• Westphal, Laura P
• Schütz, Valerie
• Inauen, Corinne
• Pokorny, Thomas
• Bracher, Katja
• Arnold, Marcel
• Fischer, Urs
• Bonati, Leo H
• De Marchis, Gian Marco
• Nedeltchev, Krassen
• Kahles, Timo
• Cereda, Carlo
• Kägi, Georg
• Montaner, Joan
• Bustamante, Alejandro
• Palà, Elena
• Ntaios, George
• Foerch, Christian
• Luft, Andreas
• Spanaus, Katharina
• Saleh, Lanja
• von Eckardstein, Arnold
• Arnold, Markus
• Katan, Mira

Titel

Serum S-100B adds incremental value for the prediction of symptomatic intracranial hemorrhage and brain edema after acute ischemic stroke

Ist Teil von

• European stroke journal, 2023-03, Vol.8 (1), p.309-319

Ort / Verlag

London, England: SAGE Publications

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: Early identification of patients developing symptomatic intracranial hemorrhage and symptomatic brain edema after acute ischemic stroke is essential for clinical decision-making. Astroglial protein S-100B is a marker of blood-brain barrier disruption, which plays an important role in the formation of intracranial hemorrhage and brain edema. In this study, we assessed the prognostic value of serum S-100B for the development of these complications. Methods: Serum S-100B levels were measured within 24 h from symptom onset in 1749 consecutive acute ischemic stroke patients from the prospective, observational, multicenter BIOSIGNAL cohort study (mean age 72.0 years, 58.3% male). To determine symptomatic intracranial hemorrhage or symptomatic brain edema, follow-up neuroimaging was performed in all patients receiving reperfusion therapy or experiencing clinical worsening with an NIHSS increase of ⩾4. Results: Forty six patients (2.6%) developed symptomatic intracranial hemorrhage and 90 patients (5.2%) developed symptomatic brain edema. After adjustment for established risk factors, log10S-100B levels remained independently associated with both symptomatic intracranial hemorrhage (OR 3.41, 95% CI 1.7–6.9, p = 0.001) and symptomatic brain edema (OR 4.08, 95% CI 2.3–7.1, p < 0.001) in multivariable logistic regression models. Adding S-100B to the clinical prediction model increased the AUC from 0.72 to 0.75 (p = 0.001) for symptomatic intracranial hemorrhage and from 0.78 to 0.81 (p < 0.0001) for symptomatic brain edema. Conclusions: Serum S-100B levels measured within 24 h after symptom onset are independently associated with the development of symptomatic intracranial hemorrhage and symptomatic brain edema in acute ischemic stroke patients. Thus, S-100B may be useful for early risk-stratification regarding stroke complications.