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BLOOD BIOMARKERS TO GUIDE THERAPEUTIC HYPOTHERMIA IN ISCHEMIC STROKE. RESULTS FROM THE EUROHYP-1 STUDY

出版	2017
URL	http://books.google.com.hk/books?id=2j22zQEACAAJ&hl=&source=gbs_api

註釋INTRODUCTIONTherapeutic hypothermia is a promising candidate for stroke treatment. However, some adverse events, such as infections, might complicate stroke outcome. We aimed to assess whether blood biomarkers might be associated with the therapeutic benefit or adverse events of hypothermia.METHODSThe EuroHYP-1 study (EudraCT number 2012-002944-25) was a randomized multicenter clinical trial comparing the efficacy of therapeutic hypothermia initiated within 6 hours after stroke vs. best medical treatment (BMT). Blood samples were obtained at three time-points; baseline (before hypothermia initiation), within the first hour after rewarming, and 72 hours after stroke. A panel of 27 biomarkers including matrix metalloproteinases (MMPs), cardiac, inflammatory-immunity and glial markers was measured and correlated with the therapeutic effect of hypothermia and with hypothermia-induced complications.RESULTSFrom the included patients, 54 (27-therapeutic arm, 27-BMT arm) had blood samples for biomarker measurement. MMPs and cardiac markers were slightly modified by treatment. Elevations on some inflammatory-immunity markers were noted in therapeutic arm, such as CRP, IL-6, IL-8, TNF-R1, PCT, copeptin or LBP. Results were barely changed when excluding from the analysis those patients who developed infections. Raised levels of copeptin, PCT, IL-8 or LBP were associated with further infections just in therapeutic arm. Hypothermia treatment was associated with reduced levels of GFAP at 72 hours (p=0.046).CONCLUSIONSAlthough limited by the sample size, our results point to the usefulness of blood biomarkers to guide hypothermia in acute stroke for predicting adverse events such as infections. In addition, GFAP might constitute a surrogate marker for the efficacy of hypothermia.