TUMOR NECROSIS FACTOR-RELATED APOPTOSIS-INDUCING LIGAND (TRAIL) IS ASSOCIATED WITH CARDIAC INJURY AND STROKE SEVERITY IN PATIENTS AFTER ACUTE ISCHEMIC STROKE

Stroke is accompanied by pathological disturbances leading to autonomic dysfunction and systemic inflammation. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a protein involved in several pathological conditions including cardiovascular diseases. We aimed to assess TRAIL level dynamic changes and its relation to stroke severity, impact on short-term outcome and association with markers of cardiac injury in patients after acute ischemic stroke (AIS).

In our study 104 patients after AIS were enrolled. Blood samples were obtained from patients at the time of admission, 24- and 48-hours later to determine level of TRAIL, NT-proBNP, and hs-TnI. Twelve lead ECG at admission, 24-, 48-hours later were obtained. Neurological examination including NIHSS at admission and modified Rankin Scale (mRS) at 90 days following the patient's discharge from the hospital were performed.

In the results we observed association between lower TRAIL and NT-proBNP elevation at admission, after 24 and 48 hours of hospitalization and there was negative association between TRAIL and hs-cTnI at admission. Moreover, we observed a connection between lower TRAIL and stroke severity evaluated by NIHSS on first day. Lower TRAIL showed significant association with severe disability and death evaluated by mRS at 90 days both after 24- and 48 hours of hospitalization. Lower TRAIL was associated with the occurrence of PVCs and prolonged QTc interval.

Our study showed, that lower TRAIL is associated with stroke severity, unfavorable functional outcome and short term mortality in patients after acute ischemic stroke. Moreover, we described association with markers of cardiac injury and ECG changes. It is necessary to distinguish whether these abnormalities presenting in stroke patients are caused by coexisting ischemic heart disease or by brain injury directly.