Serum neuron specific enolase level as a predictor of prognosis in acute ischemic stroke patients after intravenous thrombolysis

• DOI: 10.1016/j.jns.2015.10.034
• Publication Date: 2015-10-24T23:18:50Z
• Authors: Kaili Lu; Xiaofeng Xu; Shasha Cui; Feng Wang; Bin Zhang; Yuwu Zhao
• Keywords: Male; Middle Aged; Severity of Illness Index; Statistics, Nonparametric; Brain Ischemia; Stroke; Electrocardiography; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Fibrinolytic Agents; Phosphopyruvate Hydratase; Tissue Plasminogen Activator; Disease Progression; Humans; Regression Analysis; Administration, Intravenous; Female; Aged

Serum neuron specific enolase (NSE) concentrations are significantly correlated with stroke severity and clinical outcome in ischemic stroke patients. We aimed to determine whether the serum levels of neuron specific enolase in acute ischemic stroke (AIS) patients after intravenous thrombolysis are associated with stroke severity, and indicative of favorable outcome.We prospectively analyzed the serum neuron specific enolase levels with for 67 subjects with AIS patients treated with intravenous recombinant tissue type plasminogen activator (rtPA) within 4.5h from symptom onset. Neurologic deficit was assessed by the National Institutes of Health Stroke Scale. Clinical outcome was assessed after 90days according to the modified Rankin Scale.Neuron specific enolase levels correlated with National Institutes of Health Stroke Scale score 24h after rtPA bolus (R=0.342, p=0.005). Regarding the 67 included patients, 32 (47.8%) reached favorable outcome. They had a lower NIHSS score on admission (p=0.000) and at 24h after rtPA bolus (p=0.000), and had lower levels of neuron specific enolase (p=0.006). But only NIHSS score at 24h after rtPA bolus rather than neuron specific enolase level was an independent predictor for favorable outcome.We found that after treatment with intravenous rtPA therapy, lower serum neuron specific enolase levels were associated with favorable outcome, which may be confounded by the link to NIHSS score.