Serum level and prognostic value of neopterin in patients after ischemic stroke

Background: We hypothesized that serum level of neopterin is significantly predictive of prognostic outcome in patients after acute ischemic stroke (IS). Methods: Between November 2008 and May 2010, serum levels of neopterin were prospectively collected at 48. h after acute IS in 157 patients. Results: Serum neopterin levels were substantially higher in patients with severe neurological impairment [National institutes of Health Stroke Scale (NIHSS) score ≥. 12] than in those with NIHSS < 12 (p < 0.008). Furthermore, Spearman's test showed a strongly positive correlation between neopterin level and NIHSS (p = 0.003). Multiple logistic regression analysis demonstrated that serum neopterin level was strongly and independently predictive of NIHSS ≥. 12 (p = 0.002) at 48. h after acute IS and 90-day major adverse clinical outcome (defined as NIHSS. ≥. 12, recurrent stroke or death) (p = 0.003). Conclusion: Serum level of neopterin was notably increased after acute IS. This biomarker was strongly and independently predictive of 90-day unfavorable clinical outcome in patients after acute IS.