Meteorin-Like Protein Levels Decrease in Patients With Acute Ischaemic Stroke.

INTRODUCTION:  Ongoing research aims to investigate blood-based biomarkers and use them in acute ischaemic stroke (AIS) diagnosis and management of patients with AIS. PURPOSE: The purpose of the present study was to investigate the meteorin-like protein (Metrnl) levels secreted by adipose tissue in patients with AIS. METHODS: The study groups included healthy controls (n=30) and patients diagnosed with AIS via magnetic resonance imaging (MRI) in the emergency department (n=35) during the one-year period. The basic laboratory values and Metrnl, total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) levels of the patients were compared. The Metrnl levels were measured using enzyme-linked immunosorbent assays. RESULTS: In the present study, the Metrnl (p=0.001) and TAC (p=0.009) levels decreased significantly, whereas the TOS (p<0.001) and OSI (p<0.001) levels increased significantly in the patients with AIS compared to the healthy controls. Furthermore, a cut-off value of ≤1.63% meteorin-like protein rendered the sensitivity and specificity rates of 91.43% and 71.43%, respectively, in the patients with AIS. In addition, there was a significant negative correlation between the decreased meteorin-like protein levels and the infarct diameter in patients with AIS. CONCLUSION: In patients with AIS, the meteorin-like protein levels decreased inversely with the infarct diameter, and at the same time, there was an increase in TOS and OSI levels and a decrease in TAC levels.

Diagnostic and Prognostic Relevance of Serum Irisin Level in Patients with Pulmonary Embolism.

BACKGROUND: We aimed to determine the diagnostic and prognostic value of serum irisin level in patients with acute pulmonary embolism (PE) admitted to the emergency department. METHODS: Ninety patients who underwent computed tomography pulmonary angiography (CTPA) due to suspected PE were included in the study. Demographic data, PE risk factors, and associated diseases, vital signs, Wells score, Revised Geneva score, pulmonary embolism severity index (PESI), and simplified PESI (sPESI) were recorded. Irisin levels were measured by enzyme linked-immunosorbent assay. RESULTS: Serum irisin level in patients with confirmed PE (n = 45) was significantly lower than that in patients (n = 45) without PE (p = 0.001). On receiver operating characteristic curve analysis, use of optimal irisin cutoff level of 8.6 µg/mL for diagnosis of PE was associated with 82.2% sensitivity, 60% specificity, 67.3% positive predictive value (PPV), and 77.1% negative predictive value (NPV) [area under the curve (AUC): 0.744, 95% confidence in-terval (CI): 0.641 - 0.830, p < 0.001)]. Use of optimal D-dimer cutoff level of 1,720 µg/L was associated with 86.7% sensitivity, 62.2% specificity, 69.6% PPV, and 82.4% NPV (AUC: 0.801, 95% CI: 0.704 - 0.878, p < 0.001). Irisin level showed no significant correlation with Wells score or revised Geneva score; however, irisin level showed a significant negative correlation with PESI and sPESI. CONCLUSIONS: Patients with acute PE showed significantly lower serum levels of irisin. The sensitivity, specificity, NPV, and PPV of irisin level for diagnosis of PE were lower than those of D-dimer.

Evaluation of Hematological Parameters in the Differentiation of Subarachnoid Hemorrhage and Other Headache Syndromes.

BACKGROUND: In this research, the aim was to compare hematological data for the differentiation of subarachnoid hemorrhage, migraine attack, and other headache syndromes during consultation in emergency service. METHODS: In this research, which was designed as retrospective case control study, hematological parameters (WBC, HgB, HCT, PLT, lymphocyte and neutrophile counts and neutrophile/lymphocyte rates) of the patients consulting to emergency service with SAH and migraine and other consulting patients complaining mainly from headache and having normal cranial CT were analysed. RESULTS: Sixty migraine attack patients (F/M:47/13), 57 SAH patients (F/M:30/27), and 53 patients except migraine having normal brain CT (F/M:36/17) who were consulted to emergency service with headache complaint were included in our research. WBC, Hct, HgB, MCV, PLT, MPV, LY, Neu counts, and NY/LY rates were found to differentiate between SAH and migraine. WBC, PLT, MPV, LY, and Neu rates were found to differentiate between SAH and HS patients. Only Hct, HgB, MCV, and NY/LY rates were found to differ meaningfully between SAH and migraine patients but these rates were not found to have meaningful difference between SAH and HS patients. In addition, an increase in WBC counts and NY/LY rates and decrease in MPV counts in ROC analysis were found to be more specific for SAH. CONCLUSIONS: WBC, HgB, HCT, PLT, lymphocyte and Neu counts, and NY/LY rates can indicate distinguishing SAH and migraine. WBC, HgB, HCT, PLT, lymphocyte and Neu counts can indicate to the clinician a differentiation of SAH and other headache syndromes.

Copeptin Levels in Cerebral Infarction, Intracranial Hemorrhage and Subarachnoid Hemorrhage.

BACKGROUND: To determine copeptin levels in patients with suspected intracranial events and to determine whether copeptin levels could be used in the discrimination of cerebral infarction, intracranial hemorrhage, and subarachnoid hemorrhage in the emergency room. METHODS: Blood samples were obtained from the patients prior to imaging to determine the levels of copeptin. Patients were divided into diagnostic groups after the imaging. One hundred and seventy-six participants, who were enrolled in the study, were as follows: 50 cerebral infarction (CI) patients (M/F: 24/26), 47 intracranial hemorrhage (ICH) patients (M/F: 27/20), 29 subarachnoid hemorrhage (SAH) patients (M/F: 17/12) and 50 healthy controls. Differences and correlations between groups were analyzed. RESULTS: Plasma levels of copeptin in patients with CI, ICH, and SAH were 5.49 ng/dL (IQR 4.73 to 6.96), 4.50 ng/dL (IQR 3.04 to 9.77), and 5.90 ng/dL (IQR 3.11 to 13.26), respectively. It was found to be 2.0 ng/dL (IQR 1.57 to 2.5) in healthy volunteers. There was no significant correlation between copeptin levels and Intracerebral Hemorrhage Score (ICHS) (r = 0.231, p = 0.118). However, significant positive correlation was found between copeptin levels with the National Institutes of Health Stroke Scale (NIHSS) (r = 0.365, p = 0.009) and the BotterelHunt and Hess Scale (BHHS) (r = 0.590, p = 0.001). The copeptin levels of 41 (32.5%) patients who died were found to be significantly higher than those 85 (67.5%) patients who were discharged (p < 0.001). CONCLUSIONS: Copeptin levels in patients with CI, ICH, and SAH are significantly higher than healthy volunteers, but the plasma level of copeptin is not decisive in the discrimination of CI, ICH, and SAH.

Serum Salusin Levels in ST-Segment Elevation Myocardial Infarction.

BACKGROUND: In our study, we aimed to determine the change in levels of salusin-alpha and salusin-beta at admission and after the treatment in patients with STEMI, who have active atherosclerosis. METHODS: Serum salusin-alpha and beta levels of 50 patients diagnosed with STEMI in the emergency department were measured at admission and on 7th day post-treatment and compared with serum salusin levels of 50 healthy volunteers. RESULTS: In STEMI patients, salusin-alpha levels were found to be significantly decreased (p < 0.001) and salusinbeta levels were found to be significantly increased (p < 0.001) compared to healthy volunteers in the control group. 7th day post-treatment salusin-alpha levels were found to be lower and salusin-beta levels were found to be at a higher level compared to healthy individuals (p < 0.001). Negative correlation (r = -.322 p = 0.023) was found between salusin-alpha levels and pulse rate. But no significant correlation was found between salusin-beta levels and biochemical parameters. CONCLUSIONS: The data of this study support the fact that salusin-alpha levels decrease and salusin-beta levels increase in acute cases such as STEMI.