Multiple atherosclerosis-related biomarkers associated with short- and long-term mortality after stroke

We investigated the relationships of biomarkers of various pathophysiologic pathways including high-sensitivity C-reactive protein (hs-CRP), lipocalin-2 (LCN2), myeloperoxidase (MPO) and matrix metalloproteinases 9 (MMP9) with mortality in stroke patients. hs-CRP, LCN2 and MPO concentrations in 92 patients were determined using enzyme-linked immunosorbent assays. MMP9 mRNA concentrations were determined using real-time quantitative reverse transcription-polymerase chain reaction. Twelve patients (13.0%) died at 6months and 34 patients (37.0%) died at 5years. The independent predictors for 6-month mortality were hs-CRP (adjusted OR=16.0) and LCN2 (adjusted OR=16.9), while for 5-year mortality was hs-CRP (adjusted OR=5.56). For patients with hs-CRP >3.4mg/L, an increase in LCN2 was associated with 2.5-fold higher 6-month mortality, while an increase in normalized MMP9 mRNA was associated with 5.8-fold higher 6-month and 1.5-fold higher 5-year mortality. hs-CRP was the most significant independent predictor of both short- and long-term mortality after stroke, with LCN2 and MMP9 mRNA each adding further to the risk stratification. ► The 6-month and 5-year mortality rates were 13.0% and 37.0% respectively. ► hs-CRP was the independent predictor of 6-month and 5-year mortality after stroke. ► LCN2 was the independent predictor of 6-month mortality after stroke. ► Combination of hs-CRP with either LCN2 or MMP9 further improves risk stratification. ► MPO was not significantly associated with mortality after stroke.