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There is no single blood marker for predicting the prognosis in ischemic stroke. A combination of multiple blood markers may enhance the ability to predict long-term outcome following ischemic stroke.    Methods  Blood concentrations of neuronal markers (neuron-specific enolase, visinin-like protein 1, heart type fatty acid binding protein (hFABP) and neuroglobin), astroglial markers (S100B and glial fibrillary acidic protein), inflammatory markers (IL-6, TNF-α, and C-reactive protein), blood-brain barrier marker (matrix metalloproteinase 9), and haemostatic markers (D-dimer and PAI-1) were measured within 24 hours after stroke onset. The discrimination and reclassification for favorable and poor outcome were compared after adding individual or a combination of blood markers to the clinical model of stroke outcome.    Results  In multivariate analysis, natural log-transformed ( log ) IL-6 (odds ratio (OR): 1.75, 95% CI: 1.25 to 2.25,  P  = 0.001) and  log hFABP (OR: 3.23, 95% CI: 1.44 to 7.27,  P  = 0.005) were independently associated with poor outcome. The addition of a single blood marker to the clinical model did not improve the discriminating ability of the clinical model of stroke outcome. However, the addition of the combination of  log IL-6 and  log hFABP to the clinical model showed improved discrimination (area under receiver operating characteristic (AUROC) curve: 0.939 versus 0.910,  P  = 0.03) and reclassification performance (net reclassification improvement index: 0.18,  P  = 0.005).    Conclusions  A combination of circulating IL-6 and hFABP level has an additive clinical value for the prediction of stroke outcome.

critical care

Predictive value of circulating interleukin-6 and heart-type fatty acid binding protein for three months clinical outcome in acute cerebral infarction: multiple blood markers profiling study