Document Detail


Biomarkers of hypercoagulability and inflammation in childhood-onset arterial ischemic stroke.
MedLine Citation:
PMID:  20022340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the hypothesis that acute elevations of biomarkers of hypercoagulability and inflammation are common in children with arterial ischemic stroke (AIS), particularly among etiologic subtypes that carry an increased risk of recurrent stroke. STUDY DESIGN: In this prospective/retrospective institutional-based cohort study of acute childhood-onset AIS (n = 50) conducted between 2005 and 2009, D-dimer, factor VIII (FVIII) activity, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were serially evaluated at the time of clinical blood sampling. Patients were classified by stroke subtype as cardioembolic, moyamoya, non-moyamoya arteriopathy, or other. RESULTS: Both D-dimer and CRP were frequently elevated in acute childhood-onset AIS and exhibited a decreasing trend with time. Acute D-dimer levels were significantly higher in cardioembolic AIS compared with noncardioembolic AIS (median, 2.04 microg/mL [range 0.54-4.54 microg/mL] vs 0.32 microg/mL [0.22-3.18 microg/mL]; P = .002). At an optimal threshold of > or = 0.50 microg/mL, the sensitivity and specificity of D-dimer for cardioembolic subtype were 78% and 79%, respectively. CONCLUSIONS: Our findings identify D-dimer and CRP as candidate biomarkers for etiology and prognosis in childhood-onset AIS. Further studies should investigate the role of these and other biomarkers of hypercoagulability and inflammation in childhood-onset AIS.
Authors:
Timothy J Bernard; Laura Z Fenton; Susan D Apkon; Richard Boada; Greta N Wilkening; C Corbett Wilkinson; Jennifer B Soep; Shelley D Miyamoto; Mark Tripputi; Jennifer Armstrong-Wells; Timothy A Benke; Marilyn J Manco-Johnson; Neil A Goldenberg
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2009-12-21
Journal Detail:
Title:  The Journal of pediatrics     Volume:  156     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  651-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Mosby, Inc. All rights reserved.
Affiliation:
Department of Pediatrics, Section of Child Neurology, Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver and The Children's Hospital, Aurora, CO 80045-0507, USA. timothy.bernard@ucdenver.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age of Onset
Biological Markers / blood*
Brain Ischemia / blood,  epidemiology,  etiology*
C-Reactive Protein / metabolism
Child
Child, Preschool
Colorado / epidemiology
Factor VIII / metabolism
Female
Fibrin Fibrinogen Degradation Products / metabolism
Follow-Up Studies
Humans
Incidence
Inflammation / blood*,  complications
Male
Prognosis
Prospective Studies
Retrospective Studies
Risk Factors
Thrombophilia / blood*,  complications
Time Factors
Grant Support
ID/Acronym/Agency:
1K23HL084055-01A1/HL/NHLBI NIH HHS; KL2RR025779/RR/NCRR NIH HHS; UR6/CCU820552//PHS HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D; 9001-27-8/Factor VIII; 9007-41-4/C-Reactive Protein

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