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

We hypothesized that serum level of neopterin is significantly predictive of prognostic outcome in patients after acute ischemic stroke (IS). Between November 2008 and May 2010, serum levels of neopterin were prospectively collected at 48 h after acute IS in 157 patients. 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). 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. ► Serum neopterin level was notably increased after acute ischemic stroke (IS). ► Serum neopterin level predicted severity of extra-cranial carotid artery stenosis. ► Serum neopterin level independently predicted NIHSS ≥ 12 at 48 h after acute IS. ► Neopterin level independently predicted 90-day major adverse clinical outcome.