Increased level of procalcitonin is associated with total MRI burden of cerebral small vessel disease in patients with ischemic stroke.

Abstract

Procalcitonin (PCT) has been found to be associated with subclinical cerebrovascular damage. The relationship between PCT levels and cerebral small vessel disease (cSVD), especially cSVD burden, has not been fully understood. This study aimed to investigate the association between PCT levels and cSVD in patients with first-ever acute ischemic stroke or transient ischemic attack (TIA). Two hundred and seventy-eight consecutive patients were prospectively recruited during Jan 2016 to Jun 2017. Serum PCT concentrations measurement was performed after admission. The presence and burden of cSVD was determined by magnetic resonance imaging (MRI). Multivariable logistic regression was used to assess whether serum PCT levels were associated with cSVD. The median PCT level was 0.042μg/L (interquartile range, 0.025-0.065μg/L). Univariable logistic regression analysis indicated that patients with PCT level in the top quartile, compared with the lowest quartile, were more likely to have silent lacunar infarctions [odds ratio (OR), 2.266; 95% confidence interval (CI) 1.131-4.538, P=0.021], white matter lesions (OR, 1.793; 95% CI 1.029-3.574, P=0.047), high-grade enlarged perivascular spaces (OR, 8.061; 95% CI 3.599-14.055, P=0.001) and increased total MRI cSVD burden (OR, 3.743; 95% CI 1.998-7.008, P=0.002). These results persisted even after adjusting for potential confounders. This study demonstrated that elevated PCT levels might be associated with total MRI cSVD burden in patients with ischemic stroke or TIA.