***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : The cytokine interleukin (IL)-1 mediates ischaemic brain damage in rodents . The endogenous , highly selective , IL-1 receptor antagonist ( IL-1ra ) protects against ischaemic cerebral injury in a range of experimental setting s , and IL-1ra causes a marked reduction of cell death when administered peripherally or at a delay in transient cerebral ischaemia . We report here the first r and omised , double blind , placebo controlled trial of recombinant human IL-1ra ( rhIL-1ra ) in patients with acute stroke . Methods : Patients within 6 hours of the onset of symptoms of acute stroke were r and omised to rhIL-1ra or matching placebo .  Test treatment was administered intravenously by a 100 mg loading dose over 60 seconds , followed by a 2 mg/kg/h infusion over 72 h. Adverse events and serious adverse events were recorded for up to 3 months , serial blood sample s were collected for biological markers up to 3 months , and 5–7 day brain infa rct volume was measured by computed tomography . Results : No adverse events were attributed to study treatment among 34 patients r and omised . Markers of biological activity , including neutrophil and total white cell counts , C reactive protein , and IL-6 concentrations , were lower in rhIL-1ra treated patients . Among patients with cortical infa rcts , clinical outcomes at 3 months in the rhIL-1ra treated group were better than in placebo treated . Conclusions : These data suggest that rhIL-1ra is safe and well tolerated in acute stroke . In addition , rhIL-1ra exhibited biological activity that is relevant to the pathophysiology and clinical outcome of ischaemic stroke . Our findings identify rhIL-1ra as a potential new therapeutic agent for acute stroke Background and Purpose . Inflammation exists in inception , progression , and reperfusion of acute ischemic stroke . Insightful underst and ing of correlation in inflammatory mediators and stroke severity with intracranial artery stenosis may improve rational stroke therapy . Methods . We prospect ively recruited 977 patients with acute noncardioembolic ischemic stroke with MCA stenosis by MRA as none to mild ( < 50 % ) , moderate ( 50–69 % ) , severe ( 70–99 % ) , or occlusive ( 100 % ) . The peripheral levels of WBC , homocysteine ( HCY ) , and high sensitivity C-reactive protein ( hs-CRP )  were recorded . All patients were assessed of 1-year outcome by mRS as favorable ( 0–2 ) or poor ( 3–6 ) . Results . The levels of WBC , HCY , and hs-CRP had no significant differences in patients with categorized MCA stenosis ( all P > 0.05 ) . Higher levels of WBC , HCY , and hs-CRP were found in patients with 1-year poor outcome ( all P < 0.05 ) , but only hs-CRP is an independent predictor ( OR 1.06 , 95 % CI 1.027–1.093 , P = 0.0003 ) . The combination of any two of increased hs-CRP ( > 3 mg/L ) , WBC ( > 6.91 × 109/L ) , and HCY ( > 15 μmol/L ) had higher power in predicting 1-year poor outcome than the single elevated mediator . Conclusions . Elevated hs-CRP independently predicts 1-year poor outcome in acute stroke . The combination of increased hs-CRP , WBC , or HCY had a stronger predictive value in poor outcome than individual elevated mediator BACKGROUND Statins reportedly have anti-inflammatory effects aside from their cholesterol-lowering effect . We investigated the effects of statins on serum hs-CRP level and clinical outcome of acute ischemic stroke ( IS ) patients . METHODS This prospect i ve cohort study consequently evaluated patients with acute IS in a single medical center .  Serum hs-CRP levels were measured at different time points ( within 48 h and 30 days post-stroke ) . The patients ' clinical and laboratory data on admission were analyzed . RESULTS Total 100 patients with acute IS were divided in the statin group ( n=50 ) and the non-statin group ( n=50 ) . Serum hs-CRP level was similar in the 2 groups within 48 h after acute IS , but was significantly lower in the statin group on Day 30 compared to the non-statin group ( p<0.05 ) . The statin group also had favorable 3-month outcome compared to the non-statin group ( p<0.05 ) . After adjustments for covariance using stepwise logistic regression , only NIHSS on admission ( OR=1.38 , 95 % CI=1.06 - 1.80 ; p=0.02 ) and hs-CRP in the acute phase ( OR=1.74 , 95 % CI=1.30 - 2.33 ; p=0.001 ) were significantly and independently predictive of 3-month outcome . CONCLUSION Statin therapy reduces serum hs-CRP level and may be associated with favorable 3-month outcome in patients after acute IS Background Inflammation is known to worsen cerebral damage at the acute phase of stroke . In this setting , cell adhesion molecules ( CAMs ) play a crucial role mediating migration of immune cells into the infa rct ed area . However , their value in long-term outcome prediction for patients with cerebrovascular diseases ( CVD ) is less described . Methods Levels of four CAMs ( E-selectin , P-selectin glycoprotein lig and -1 , intercellular adhesion molecule-1 , and vascular cell adhesion molecule-1 ( VCAM-1 ) ) and six other known biomarkers ( C-reactive protein ( CRP ) , interleukin-6 ( IL-6 ) , N-terminal pro-brain natriuretic peptide ( NT-proBNP ) , troponin I , vasopressin-neurophysin 2-copeptin , and S100 calcium-binding protein B ) were measured in a population of patients presenting CVD .  Blood collection s for analysis were performed within different time windows after stroke onset : 0–6 h , 6–36 h , 2–3 days , 5–7 days , and 2–3 weeks . Independent associations with poor outcome at 3 months ( modified Rankin Scale score > 2 ) were sought using univariate and multivariate analysis after adjustments for age and National Institute of Health Stroke Scale score . Predictive ability of each biomarker has also been assessed with ROC analysis . Results One hundred patients were prospect ively included whom 75 presented with ischemic strokes , nine with hemorrhagic strokes and 16 with transient ischemic attacks . During the first 6 h after stroke onset , E-selectin was found to be an independent predictor of 3-month outcome ( odds ratio ( OR ) = 24 ; 95 % confidence interval ( 95 % CI ) , 2–354 ; p = 0.022 ) ( area under the curve ( AUC ) = 78 % ) , as was VCAM-1 during the third week after onset ( OR = 8 ; 95 % CI , 2–37 ; p = 0.01 ) ( AUC = 73 % ) . Associations remained after the exclusion of patients with hemorrhagic strokes and transient ischemic attacks . Independent associations with outcome were also found for CRP ( OR = 5 ; 95 % CI , 1–22 ; p = 0.023 ) and IL-6 ( OR = 5 ; 95 % CI , 1–17 ; p = 0.021 ) at 2–3 days and for NT-proBNP at 6–36 h ( OR = 20 ; 95 % CI , 1–337 ; p = 0.04 ) . Conclusions E-selectin and VCAM-1 were independent predictors of outcome in a population of patients with CVD . The predictive capability of other biomarkers known to be indicators for prognosis also emerged , confirming the study ’s robustness . CAMs levels could be considered as objective biological criteria for prognosis in CVD Background and Purpose — There is growing evidence of the prognostic importance of C-reactive protein ( CRP ) in ischemic stroke . However , the independent value of CRP at different stages after stroke has not been established . Therefore , we assessed the prognostic values of CRP in ischemic stroke . We also compared the relation of CRP at admission and discharge with 1-year outcome . Methods — One hundred ninety-three patients were included in a derivation set ( n=128 ) and a validation set ( n=65 ) . Serum CRP  was measured , within 24 hours after index ischemic stroke , within 48 to 72 hours , and at hospital discharge . We examined the association between the level of  CRP  at different stages after stroke and outcome . We adjusted for the possible confounding effect using a multivariate Cox proportional hazard model . Results — A cutoff point of 1.5 mg/dL for CRP at discharge provided optimum sensitivity and specificity for adverse outcome , based on the receiver operator curves .  CRP  at admission ( hazard ratio [ HR ] 2.78 , 95 % CI 1.45 to 5.33;P = 0.0021 ) and discharge ( HR 9.42 , 95 % CI 4.27 to 19.05;P < 0.0001 ) were predictors of the combined end point of new vascular events or death at 1 year .  CRP at hospital discharge was the strongest independent marker of adverse outcome ( HR 7.42 , 95 % CI 2.75 to 20.03;P = 0.0001 ) . These results were confirmed in the validation set ( HR 15.66 , 95 % CI 3.36 to 72.97;P = 0.0005 ) . Conclusions — CRP is a marker of increased 1-year risk in ischemic stroke . CRP at discharge is better related to later outcome and could be of greater utility for risk stratification . These findings are consistent with the hypothesis that elevated CRP may predict future cardiovascular events or death Background Cerebral ischaemia initiates an inflammatory response in the brain and periphery . We assessed the relationship between peak values of plasma interleukin-6 ( IL-6 ) in the first week after ischaemic stroke , with measures of stroke severity and outcome . Methods Thirty-seven patients with ischaemic stroke were prospect ively recruited . Plasma IL-6 , and other markers of peripheral inflammation , were measured at pre-determined timepoints in the first week after stroke onset . Primary analyses were the association between peak plasma IL-6 concentration with both modified Rankin score ( mRS ) at 3 months and computed tomography ( CT ) brain infa rct volume . Results Peak plasma IL-6 concentration correlated significantly ( p < 0.001 ) with CT brain infa rct volume ( r = 0.75 ) and mRS at 3 months ( r = 0.72 ) . It correlated similarly with clinical outcome at 12 months or stroke severity . Strong associations were also noted between either peak plasma C-reactive protein ( CRP ) concentration or white blood cell ( WBC ) count , and all outcome measures . Conclusions These data provide evidence that the magnitude of the peripheral inflammatory response is related to the severity of acute ischaemic stroke , and clinical outcome Inflammatory markers have been associated with functional outcome and mortality of stroke . We investigated the changes in  procalcitonin ( PCT ) and  high-sensitivity C-reactive protein ( Hs-CRP ) levels during the acute period of ischemic stroke and evaluated the relationship between these levels and the long-term functional outcome and mortality . We prospect ively studied 376 patients with acute ischemic stroke ( AIS ) who were admitted within 24 h after the onset of symptoms .  PCT , Hs-CRP , and NIH Stroke Scale ( NIHSS )  were measured at the time of admission . Long-term functional outcome were measured by modified Rankin scale ( mRS ) at 1 year after admission . The correlations between the levels of PCT , Hs-CRP  , and mortality at 1 year after stroke onset were analyzed . Patients with poor with functional outcome  and non-survivors had significantly increased PCT and Hs-CRP levels on admission . Multivariate logistic regression analysis showed that  PCT  was an independent prognostic marker of 1-year functional outcome and death [ odds ratio ( OR ) 2.33 ( 95 % CI , 1.33–3.44 ) and 3.11 ( 2.02–4.43 ) , respectively , P < 0.0001 for both , adjusted for age , NIHSS , other predictors , and vascular risk factors ] in patients with AIS . The area under the receiver operating characteristic curve of PCT was 0.77 ( 95 % CI , 0.72–0.83 ) for functional outcome and 0.88 ( 95 % CI , 0.84–0.93 ) for  mortality .  PCT improved the area under the receiver operating characteristic curve of the NIHSS score for functional outcome from 0.74 ( 95 % CI , 0.66–0.81 ) to 0.85 ( 95 % CI , 0.76–0.92 ; P < 0.0001 ) and for mortality from 0.77 ( 95 % CI , 0.70–0.83 ) to 
    Output:
    
Globally , we identified uncertainty with regard to the association of the evaluated biomarkers with stroke outcome , with little added value on top of clinical predictors such as age or stroke severity , which makes its implementation unlikely in clinical practice for global outcome prediction .