Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial.

Appleton, Jason P, O'Sullivan, Saoirse E, Hedstrom, Amanda, May, Jane A, Donnelly, Richard, Sprigg, Nikola, Bath, Philip M and England, Timothy J (2020) Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial. European journal of neurology. ISSN 1468-1331. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://onlinelibrary.wiley.com/journal/10.1111/(IS...

Abstract

BACKGROUND

Remote ischaemic per-conditioning (RIC) is neuroprotective in experimental ischaemic stroke. Several neurohumoral, vascular and inflammatory mediators are implicated. We assessed the effect of RIC on plasma biomarkers using clinical data from the REmote ischaemic Conditioning After Stroke Trial (RECAST-1).

METHODS

RECAST-1 was a pilot sham-controlled blinded trial in 26 patients with ischaemic stroke, randomised to receive four 5-minute cycles of RIC within 24 hours of ictus. Plasma taken pre-intervention, immediately post-intervention and on day 4 was analysed for nitric oxide (nitrate/nitrite) using chemiluminescence and all other biomarkers by multiplex analysis. Biomarkers were correlated with clinical outcome (day 90 National Institutes of Health Stroke Scale [NIHSS], modified Rankin scale [mRS], Barthel index [BI]).

RESULTS

RIC reduced serum amyloid protein (SAP) and tissue necrosis factor-α (TNF-α) levels from pre- to post-intervention (n=13, 2-way ANOVA, p<0.05). Overall (n=26), increases in SAP pre- to post intervention and pre-intervention to day 4 were moderately-correlated with worse day 90 clinical outcomes. No consistent significant changes over time, or by treatment, or correlations with outcome were seen for other biomarkers.

CONCLUSIONS

RIC reduced SAP and TNF-α levels from pre- to post-intervention. Increases in plasma levels of SAP were associated with worse clinical outcomes after ischaemic stroke. Larger studies assessing biomarkers, safety and efficacy of RIC in acute ischaemic stroke are warranted to further understand these relationships.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WL Nervous system. Neurology
Divisions: Emergency Services > Neurology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 30 Nov 2020 12:24
Last Modified: 30 Nov 2020 12:24
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3740

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