Blood markers of inflammation and endothelial dysfunction in cardioembolic stroke: systematic review and meta-analysis

Abstract

Context: Various processes including inflammation and endothelial dysfunction have been implicated in the pathogenesis of cardioembolic (CE) strokes.

Objective: To review the evidence and investigate the association between immune-inflammatory biomarkers and CE strokes versus other stroke subtypes.

Methods: We systematically reviewed the literature (sources: MEDLINE, web-based register http://stroke-biomarkers.com, reference lists) with quality assessment and meta-analysis of selected articles.

Results: The most consistent association was found between C-reactive protein (CRP) and CE strokes when compared to other stroke subtypes (standardized mean difference 0.223 (0.116, 0.343); p < 0.001)

Conclusions: Our findings confirm a possible association between selected inflammatory biomarkers and CE stroke.

Keywords:

• Cardiovascular disease
• biological markers
• stroke

Acknowledgments

We thank corresponding authors of articles included in the systematic review for sending additional data necessary for meta-analysis.

Authors thank Maria Elena Della Santa for technical support in preparing this article.

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This work supported by grants from Fondazione Ente Cassa di Risparmio di Firenze, Project “ICTUS: Comunicazione & Innovazione”; by grants from Italian Ministry of Health, 2011 Finalized Research Programs, Project “Reperfusion injury after cerebral ischemia: an in vivo study using neuroimaging markers” (RF-2011-02348240); by Instituto de Salud Carlos III, grant FIS PI15/354, co-financed by the European Regional Development Fund, (FEDER). A.B. is supported by a Rio Hortega contract CM/00265 from the Instituto de Salud Carlos III. Neurovascular Research Laboratory takes part in the Spanish stroke research network INVICTUS (RD12/0014/0005) and all authors collaborate in the International Biomarker in Cerebrovascular Diseases (IBCD) study group.