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Abstract
BackgroundFibulin-5 and ischemia-modified albumin (IMA) levels increase in acute phase of cerebrovascular diseases, yet data regarding their levels in various stroke subtypes and correlation with severity and prognosis are still insufficient. This work aims to evaluate serum IMA and fibulin-5 as markers for early detection and predicting prognosis in acute cerebrovascular disease.MethodThis case-control study was done on 100 patients with first time stroke, assessed by the National Institute of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) within the first 24 h after stroke event, lesion volume was calculated, serum fibulin-5 and IMA levels were measured in the first few hours of stroke, and their levels were compared with levels measured in 75 control subjects. Three months later, stroke patients were assessed by the modified Rankin Scale (MRS).ResultsFibulin-5 and IMA were significantly higher in the patient than in the control group and were positively correlated with lesion volume and NIHSS score but inversely correlated with GCS score. Fibulin-5 was statistically higher in hemorrhage group, whereas IMA was statistically higher in infarction group. MRS score was positively correlated with fibulin-5 levels at onset of stroke but not with IMA.ConclusionFibulin-5 and ischemia-modified albumin are increased during the acute stroke phase and correlated with severity of stroke, but only fibulin-5 shows significant correlation with prognosis.
Highlights
A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention [1]
Fibulin-5 was statistically higher in hemorrhage group, whereas ischemia-modified albumin (IMA) was statistically higher in infarction group
Fibulin-5 and ischemia-modified albumin are increased during the acute stroke phase and correlated with severity of stroke, but only fibulin-5 shows significant correlation with prognosis
Summary
A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention [1]. Many reports indicate that the factors involved in ischemia that can induce these in vivo changes to albumin may include acidosis, free radical damage, membrane energy-dependent sodium and calcium pump disruption, reduced oxygen tension, and free iron and copper ion exposure [7]. These conditions necessary for altering the metal binding site of human serum albumin (HAS) are known to occur within minutes of the onset of ischemia, and their effect on albumin could be detectable up to 6 h after the ischemic event [8]. This work aims to evaluate serum IMA and fibulin-5 as markers for early detection and predicting prognosis in acute cerebrovascular disease
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