Abstract
In this study, prognostic value of cerebrospinal fluid (CSF) free fatty acid (FFA) levels in patients confirmed with acute ischemic stroke (AIS) was evaluated in a Chinese population. A prospective cohort designed study was conducted at our hospital of the Emergency department from November, 2012 to September, 2014. The National Institutes of Health Stroke Scale (NIHSS) score on admission was applied to assess CSF levels of FFA and specific severity degree of stroke. Evaluation of the prognostic outcomes of those stroke patients used the modified Rankin scale scores at 90-days. Logistic regression analysis analyzed the prognostic value of FFA. NIHSS score results suggested a positive relationship between levels of CSF FFA levels and severity of stroke. There was an obviously higher trend of CSF FFA levels in patients with CE stroke than those of the non-CE stroke patients, with statistically difference (P < 0.05). Further, CSF FFA levels were evidently lower in those 73 patients with favorable outcome when compared to those with unfavorable outcomes [0.21(IQR, 0.11–0.28) mmol/L vs. 0.36 (IQR, 0.27–0.50) mmol/L, P < 0.0001, P < 0.0001]. Multivariate analysis results after possible confounders adjustment indicated that there was an increased risk of unfavorable outcome associated with CSF FFA levels ≥0.29 mmol/L (OR 5.12, 95%CI: 2.35–10.28; P < 0.0001). Collectively, CSF level of FFA at admission was suggested to be a useful, independent short-term prognostic marker in Chinese patient with AIS.
Highlights
Stroke is a leading cause of mortality and subsequent serious long-term disability among survivors (Zhang and Zhang, 2014)
cerebrospinal fluid (CSF) was collected after admission for standardized measurement of free fatty acids (FFAs) and high sensitivity C-reactive protein (Hs-CRP) in 238 patients
Interesting, we found that the patients with atrial fibrillation (AF) had elevated CSF FFA levels than others [0.33 (IQR, 0.24–0.45) mmol/L vs. 0.24 (IQR, 0.13–0.33) mmol/L, P < 0.0001]
Summary
Stroke is a leading cause of mortality and subsequent serious long-term disability among survivors (Zhang and Zhang, 2014). Optimization of medical care and allocation of health care resources play critical roles in maintaining and increasing the survival outcomes of those patients, of which rapidly measurable biomarkers identification are extremely essential (Tu et al, 2013). Novel biomarkers have emerged to assist clinicians with decision-making. FFA enters the circulatory system from lipolysis of triglycerides stored in adipocytes, and the plasma FFA concentration is closely connected with lipid metabolism (Choi et al, 2014). Elevated FFA concentration is linked to several risk factors for atherosclerosis, including ischemic stroke risk (Yaemsiri et al, 2013).
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