Tumor Necrosis Factor alpha, prognosis and stroke subtype etiology

Objective

To determine the relationship between TNF alpha and the etiology, localization, extension, intima media thickness, carotid atherosclerotic plaque, and outcome after an acute stroke.

Methods

We randomly selected 75 patients with acute strokes from a total of 253 patients that were admitted prospectively from May, 2008 to December, 2010. We analyzed TNF alpha levels and compared it with demographic data, clinical outcome upon hospital discharge, and at 3 months post discharge with neuroimaging studies. We used the Chi-square test, the U-Mann–Whiney test and the Cox logistic regression adjusted for age, gender and stroke extension.

Results

We included 47 men and 28 women. The most common etiologies were atherosclerotic (39%) and small vessel disease (27%). TNF alpha levels did not differ between atherosclerotic and cardioembolic stroke etiologies, except for the lacunar infarction, which had the lowest levels (p = 0. 048), and did not correlate with a worse functional outcome upon hospital discharge (p = 0. 852) or at 3 months following discharge (p = 0.194). Additionally, we found a positive relation between intima media thickness >1 mm and TNF alpha (p = 0. 004). TNF alpha was not associated with the extension of the stroke by an ASPECTS score with CT or MRI (p = 0.323) or with the arterial territory involved (p = 0. 289).

Conclusions

TNF alpha was not globally associated with functional outcome after acute stroke, just in the lacunar infarction, which has the lowest levels. We also found a positive relation between TNF alpha and intima-media thickness.