Cut-off values of factors in relation to predict early neurological improvement after intravenous thrombolysis : a retrospective single center study in Korea

Abstract Background: We aimed to determine cut-off values of factorsaffecting early neurological improvementin patients after recombinant tissue plasminogen activator therapy for acute ischemic stroke. Methods: A total of 135 patients with acute ischemic stroke treated with tissue plasminogen activator within 4.5 hours of stroke onset were enrolled at a single center. Therapy outcomes were based on early neurological improvement, defined as when the NIHSS score after 24 hours of tPA treatment decreased by ≥ 40% from the baseline value. Binary logistic linear regression analysis was used to identify the factors affecting early neurological improvement. Results: Sixty-nine (51.1%) patients had early neurological improvement. Multivariate analysis of these significant factors revaealed low serum homocysteine (odds ratio, 0.865; 95% confidence interval, 0.787–0.950; P=0.003) and high-sensitivity C-reactive protein (0.345; 0.203–0.586; P<0.001) levels were significantly associated with a high incidence of early neurological impairment. The cut-off values of serum homocysteine and high-sensitivity C-reactive protein were 11.99umol/L and 1.16mg/L, respectively. Conclusions: Serum homocysteine and high-sensitivity C-reactive protein were associated with early neurological improvement in patients with acute ischemic stroke who received therapy and their cut-off values mightbe promising criteriafor predicting early prognosis of acute ischemic stroke treated with intravenous thrombolysis.