Abstract Background The aim of our study was to evaluate the long-term prognostic value of blood-based biomarkers in comparison to the established National Institute of Health stroke scale (NIHSS) score in patients with acute ischemic stroke. Methods We measured plasma concentrations of IL-6, NT-proBNP, D-dimer, hs-cTnT, sST2, MR-proADM, MR-proANP, CT-proET-1, Copeptin, and Procalcitonin in 721 consecutive acute ischemic stroke patients within 24 h after admission to our stroke unit. Endpoint was all-cause mortality at 3 years. Results During follow-up, 199 patients died (28%). In univariate Cox proportional hazards regression analyses using a dichotomized approach according to median values, all blood-based biomarkers were associated with prognosis. However, in the multivariate analysis after adjustment for several clinical variables, only IL-6 >7 pg/mL (risk ratio, 3.00; 95% CI, 2.03–4.44; P<0.001), NT-proBNP >447 ng/L (risk ratio, 2.67; 95% CI, 1.81–3.92; P<0.001), NIHSS score >3 (risk ratio, 2.24; 95% CI, 1.63–3.07; P<0.001), Copeptin >13 pmol/L (risk ratio, 1.87; 95% CI, 1.34–2.61; P<0.001), and hs-cTnT >14 ng/L (risk ratio, 1.74; 95% CI, 1.21–2.49; P=0.001) remained independent predictors. ROC curve analysis for mortality prediction demonstrated a higher area under the curve (AUC) for IL-6 and NT-proBNP, respectively, when compared to the NIHSS score (IL-6 AUC 0.81 vs. NIHSS AUC 0.75; P=0.016 and NT-proBNP AUC 0.80 vs. NIHSS AUC 0.75; P=0.039) and similar AUCs when comparing the NIHSS with hs-TnT (hs-TnT AUC 0.77) and Copeptin (Copeptin AUC 0.72). Conclusions In this large cohort of patients with acute ischemic stroke the blood-based biomarkers IL-6, NT-proBNP, hs-cTnT, and Copeptin were strong and independent prognostic markers for 3-year all-cause mortality. IL-6 and NT-proBNP even outperformed the NIHSS score for long-term mortality prediction. ROC plots for 3-year all-cause mortality Funding Acknowledgement Type of funding source: None

Background: Soluble ST2 (sST2) has emerged as a strong prognostic biomarker in patients with heart failure and myocardial infarction. There is no published data on sST2 in patients with stable coronary artery disease (CAD). Therefore, the aim of this study was to evaluate the long-term prognostic value of sST2 in patients with stable CAD.

A 33-year-old previously healthy man was admitted to the hospital with a 6-day history of diffuse abdominal pain and constipation. He was afebrile, looked unwell with a pale skin and displayed an elevated blood pressure. He had no peritoneal sign, and bowel sounds were normal. Blood tests were remarkable for a hematocrit of 26 % and mean cell volume of 83 fl, bilirubin levels were slightly elevated. Abdominal radiographs, abdominal ultrasound and computed tomography showed stool throughout the colon with a non-specific bowel gas pattern. Moreover, colonoscopy and gastroscopy provided no information on the underlying cause of the patient's severe pain. He was treated with fluids and spasmolytic drugs until the result of the urinary porphyrin level was received, which showed an elevated concentration of 1608 microg/d. Consequently, the plasma lead concentration was determined showing an elevated level of 92.3 microg/d. The examination of blood slides revealed erythrocytes with basophile stippling. On physical examination, a bluish discoloration could be seen along the gums. After starting the detoxication therapy with DMPS - 1800 mg p. o. for the first two days followed by 600 mg DMPS daily - the complaints disappeared. In spite of an extensive anamnestic exploration the source of the lead intoxication could not be found until now.