Ramiro, LauraAbraira, LauraQuintana, ManuelGarcia-Rodriguez, PaulaSantamarina, Estevoalvarez-Sabin, JoseZaragoza, JosepHernandez-Perez, MariaUstrell, XavierLara, BlancaTerceño, MikelBustamante, AlejandroMontaner, Joan2023-02-092023-02-092021-02-10Ramiro L, Abraira L, Quintana M, García-Rodríguez P, Santamarina E, Álvarez-Sabín J, et al. Blood Biomarkers to Predict Long-Term Mortality after Ischemic Stroke. Life (Basel). 2021 Feb 10;11(2):135.2075-1729http://hdl.handle.net/10668/17170Stroke is a major cause of disability and death globally, and prediction of mortality represents a crucial challenge. We aimed to identify blood biomarkers measured during acute ischemic stroke that could predict long-term mortality. Nine hundred and forty-one ischemic stroke patients were prospectively recruited in the Stroke-Chip study. Post-stroke mortality was evaluated during a median 4.8-year follow-up. A 14-biomarker panel was analyzed by immunoassays in blood samples obtained at hospital admission. Biomarkers were normalized and standardized using Z-scores. Multiple Cox regression models were used to identify clinical variables and biomarkers independently associated with long-term mortality and mortality due to stroke. In the multivariate analysis, the independent predictors of long-term mortality were age, female sex, hypertension, glycemia, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Independent blood biomarkers predictive of long-term mortality were endostatin > quartile 2, tumor necrosis factor receptor-1 (TNF-R1) > quartile 2, and interleukin (IL)-6 > quartile 2. The risk of mortality when these three biomarkers were combined increased up to 69%. The addition of the biomarkers to clinical predictors improved the discrimination (integrative discriminative improvement (IDI) 0.022 (0.007-0.048), p quartile 2, tumor necrosis factor receptor-1 (TNF-R1) > quartile 2, and interleukin (IL)-6 > quartile 2. The risk of mortality when these three biomarkers were combined increased up to 69%. The addition of the biomarkers to clinical predictors improved the discrimination (integrative discriminative improvement (IDI) 0.022 (0.007-0.048), p quartile 2, and interleukin (IL)-6 > quartile 2. The risk of mortality when these three biomarkers were combined increased up to 69%. The addition of the biomarkers to clinical predictors improved the discrimination (integrative discriminative improvement (IDI) 0.022 (0.007-0.048), p quartile 2. The risk of mortality when these three biomarkers were combined increased up to 69%. The addition of the biomarkers to clinical predictors improved the discrimination (integrative discriminative improvement (IDI) 0.022 (0.007-0.048), p quartile 3 was an independent predictor of mortality due to stroke. Altogether, endostatin, TNF-R1, and IL-6 circulating levels may aid in long-term mortality prediction after stroke.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/IL-6TNF-R1biomarkerendostatinischemic strokemortalityIschemic StrokeReceptors, Tumor Necrosis Factor, Type IEndostatinsInterleukin-6Follow-Up StudiesStrokeImmunoassayMultivariate AnalysisHospitalsresearch article33578805open accessBiomarcadoresMortalidadInterleucinasEndostatinasAccidente cerebrovascular isquémicoInseminación artificial heterólogaInterleucina-6HipertensiónInmunoensayoAnálisis multivariante10.3390/life11020135PMC7916549https://www.mdpi.com/2075-1729/11/2/135/pdf?version=1613788494https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916549/pdf