Inflammation Predicts Risk for Recurrent Stroke & 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 New York-Presbyterian Hospital.

Published in the Oct. 23, 2006 Archives of Internal Medicine, results of the new study 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 the 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 New York-Presbyterian, located in Washington Heights.

Omega-3 fish oil and neptune krill oil have proven to reduce biomarkers of inflammation, such as C-reactive protein.

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

Source:

Ralph L. Sacco, M.D., M.S.; Wanling Tai, B.S.; Kristen Coates, B.S.; and, Myunghee C. Paik, Ph.D. Archives of Internal Medicine Oct. 23, 2006

Columbia University Medical Center, press release, October 24,2006

Key concepts: inflammation, stroke, mortality