Prognostic markers in ischemic stroke
Medical Review (Med. pregled), 2023, 59(5), 5-13.
T. VT. Popovska1,2, R. Kalpachki2, D. Svinarov3,4, M. Velizarova3,4
1 Department of Clinical Laboratory, UMHAT “Sv. Anna” – Sofia
2 Center for Treatment of Stroke, UMHAT “Sv. Anna” – Sofia,
3 Central Clinical Laboratory, UMHAT “Alexandrovska” – Sofia
4 Department of Clinical Laboratory, Medical University – Sofia
Abstract. According to the WHO, ischemic stroke is defined as an acute disturbance of cerebral circulation as a result of thrombosis or embolism in a certain vascular pool of the cerebral parenchyma, characterized by the rapid emergence of focal or global neurological deficit. In recent years, there has been significant progress in our knowledge of the pathophysiology of stroke. The understanding of the benefits of timely reperfusion led to the introduction of thrombolytic therapy as a cornerstone of the modern treatment of ischemic stroke. However, the scientific community still faces the challenge to study in depth the mechanisms of neuronal ischemic and reperfusion injury and immune mechanisms in the course of an acute cerebrovascular event, to search for independent or complementary biomarkers suitable for assessing the course and prognosis of the disease. The aim of this review is to explore the current knowledge of neuroimmune axis activation and cellular-molecular mechanisms in ischemic stroke, markers of inflammation and atherothrombosis, biomarkers of coagulation and fibrinolysis, and their role as indicators for management of the healing process and prognosis of the disease. The review includes information from publications in Web of Science (Clarivate) and Scopus (Elsevier) until January 15, 2023, selected by the following key words alone or in combination: prognostic markers, ischemic stroke, neutrophils, fibrinogen, D-dimer (DD), C-reactive protein (CRP). Our study shows that markers of inflammation, coagulation and fibrinolysis (neutrophils, CRP, fibrinogen, DD) alone, in combination or as ratios and indices, could be reliable candidate markers for management of recovery process and prognosis of the short-term outcome of the disease.
Key words: prognostic markers, ischemic stroke, neutrophils, C-reactive protein, fibrinogen, D-dimer
Address for correspondence: Tatyana Popovska, DM, e-mаil: tpopovska@abv.bg