Table 3. Crude associations of biomarkers and the CHADS2, CHA2DS2-VASc and HAS-BLED score with unfavourable 30-day outcome of ischemic stroke, predictive ability of each biomarker or score, and pairwise comparisons of each biomarker and stroke risk score predictive ability.
Predictive ability | Pairwise comparison | ||||||||
OR | 95%CI | P | c-statistic | 95%CI | P | z-statistic | P | ||
Biomarker | |||||||||
1 | CRP | 3.9 | 2.9–5.3 | <0.001 | 0.853 | 0.802–0.895 | <0.001 | 0.335 (1 vs. 2) | 0.7390 |
quartiles | 5.8 | 3.5–9.5 | <0.001 | 0.795 | 0.738–0.844 | <0.001 | 1.678 (1 vs. 3) | 0.0934 | |
4.616 (1 vs. 4) | <0.001 | ||||||||
5.641 (1 vs. 5) | <0.001 | ||||||||
6.081 (1 vs. 6) | <0.001 | ||||||||
2 | Fibrinogen | 61.7 | 21.1–180.7 | <0.001 | 0.848 | 0.796–0.891 | <0.001 | 1.536 (2 vs. 3) | 0.1246 |
quartiles | 4.2 | 1.9–6.0) | <0.001 | 0.835 | 0.781–0.879 | <0.001 | 4.312 (2 vs. 4) | <0.001 | |
5.530 (2 vs. 5) | <0.001 | ||||||||
5.549 (2 vs. 6) | <0.001 | ||||||||
3 | TnI | 3.2 | 2.3–4.4 | <0.001 | 0.792 | 0.736–0.842 | <0.001 | 3.249 (3 vs. 4) | 0.0012 |
quartiles | 2.7 | 2.0–3.7 | <0.001 | 0.767 | 0.705–0.830 | <0.001 | 3.441 (3 vs. 5) | 0.0006 | |
3.847 (3 vs. 6) | 0.0001 | ||||||||
4 | D-dimer | 1.9 | 1.4–2.5 | <0.001 | 0.642 | 0.578–0.703 | <0.001 | 0.371 (4 vs. 5) | 0.7109 |
quartiles | 1.6 | 1.2–2.0 | <0.001 | 0.636 | 0.572–0.697 | <0.001 | 0.626 (4 vs. 6) | 0.5313 | |
5 | WBC | 1.2 | 1.1–1.5 | 0.010 | 0.622 | 0.558–0.684 | 0.001 | 0.236 (5 vs. 6) | 0.8134 |
quartiles | 1.3 | 1.1–1.7 | <0.001 | 0.593 | 0.528–0.656 | 0.009 | |||
6 | CrCl | 0.09 | 0.04–0.59 | 0.012 | 0.610 | 0.545–0.672 | 0.004 | ||
quartiles | 0.7 | 0.5–0.7 | 0.007 | 0.601 | 0.536–0.664 | 0.006 | |||
Stroke risk score | |||||||||
7 | CHA2DS2-VASc | 7.9 | 4.6–13.4 | <0.001 | 0.932 | 0.892–0.960 | <0.001 | 4.265 (7 vs. 8) | <0.001 |
8 | CHADS2 | 10.8 | 5.6–21.0 | <0.001 | 0.872 | 0.823–0.912 | <0.001 | 3.834 (8 vs. 9) | <0.001 |
9 | HAS-BLED | 2.8 | 2.0–3.8 | <0.001 | 0.750 | 0.690–0.804 | <0.001 | 5.674 (7 vs. 9) | <0.001 |
z-statistic | P | ||||||||
CHA2DS2- | CHA2DS2-VASc vs. CRP | 2.963 | 0.0030 | ||||||
VASc score vs. biomarkers | CHA2DS2-VASc vs. Fibrinogen | 2.961 | 0.0031 | ||||||
CHA2DS2-VASc vs. TnI | 3.977 | 0.0001 |
OR, Odds Ratio; CI, Confidence Interval.
Only biomarkers with p<0.01 regarding unfavourable 30-day functional stroke outcome are shown.
CRP, C-reactive protein; WBC, white blood cell count; CrCl, creatinine clearance; CHA2DS2-VASc, congestive heart failure or left ventricular ejection fraction ≤40%, hypertension, age ≥75 years, diabetes mellitus, prior stroke or TIA, vascular disease (including myocardial infarction and peripheral artery disease), age >65 years, female gender (1 point each, age ≥75 years and prior stroke/TIA 2 points each); CHADS2, congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or TIA (1 point each, prior stroke/TIA 2 points); HAS-BLED, hypertension, abnormal renal or liver function, prior stroke, labile INRs (International Normalized Ratio), elderly (>65 years), concomitant drugs or alcohol use.