Abstract: Inflammation following ischemic brain injury is correlated with adverse outcome. Preclinical studies indicate that treatment with acetylsalicylic acid + extended-release dipyridamole (ASA + ER-DP) has anti-inflammatory and thereby neuroprotective effects by inhibition of monocyte chemotactic protein-1 (MCP-1) expression. We hypothesized that early treatment with ASA + ER-DP will reduce levels of MCP-1 also in patients with ischemic stroke. The EARLY trial randomized patients with ischemic stroke or TIA to either ASA + ER-DP treatment or ASA monotherapy within 24 h following the event. After 7 days, all patients were treated for up to 90 days with ASA + ER-DP. MCP-1 was determined from blood samples taken from 425 patients on admission and day 8. The change in MCP-1 from admission to day 8 did not differ between patients treated with ASA + ER-DP and ASA monotherapy (p > 0.05). Comparisons within MCP-1 baseline quartiles indicated that patients in the highest quartile (>217–973 pg/mL) showed improved outcome at 90 days if treated with ASA + ER-DP in comparison to treatment with ASA alone (p = 0.004). Our data does not provide any evidence that treatment with ASA + ER-DP lowers MCP-1 in acute stroke patients. However, MCP-1 may be a useful biomarker for deciding on early stroke therapy, as patients with high MCP-1 at baseline appear to benefit from early treatment with ASA + ER-DP.
Keywords: ischemic stroke; monocyte chemoattractant protein-1 (MCP-1); antithrombotic therapy; neuroprotection; dipyridamole; acetylsalicylic acid (ASA)
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Worthmann, H.; Dengler, R.; Schumacher, H.; Schwartz, A.; Eisert, W.G.; Lichtinghagen, R.; Weissenborn, K. Monocyte Chemotactic Protein-1 as a Potential Biomarker for Early Anti-Thrombotic Therapy after Ischemic Stroke. Int. J. Mol. Sci. 2012, 13, 8670-8678.
Worthmann H, Dengler R, Schumacher H, Schwartz A, Eisert WG, Lichtinghagen R, Weissenborn K. Monocyte Chemotactic Protein-1 as a Potential Biomarker for Early Anti-Thrombotic Therapy after Ischemic Stroke. International Journal of Molecular Sciences. 2012; 13(7):8670-8678.
Worthmann, Hans; Dengler, Reinhard; Schumacher, Helmut; Schwartz, Andreas; Eisert, Wolfgang G.; Lichtinghagen, Ralf; Weissenborn, Karin. 2012. "Monocyte Chemotactic Protein-1 as a Potential Biomarker for Early Anti-Thrombotic Therapy after Ischemic Stroke." Int. J. Mol. Sci. 13, no. 7: 8670-8678.