Recently elevated level of antibodies against NMDA subunit NR2 had been described as biomarker for acute cerebrovascular lesion. Arterial hypertension is powerful modifiable vascular risk factor for stroke initiation and recurrence. We aimed to determine whether serum NR2-antibodies level associated with risk of recurrent stroke in hypertensive patients.Design and Method:
High-risk hypertensive patients (n = 120) who had ischemic stroke in anamnesis were prospectively enrolled for this study. Serum concentrations of NR2-antibodies had been tested at baseline in all patients and 30 normotensive subjects (control group). Brain MRIs were assessed in all post-stroke hypertensives initially. Mean follow-up duration was 2.5 ± 1.7 years. Multivariable Cox-regression models were applied to identify risk factors for stroke recurrence.Results:
Of 120 subjects enrolled, recurrent ischemic stroke occurred in 14 (11.7%) patients. Baseline mean NR2 peptide antibodies level was 3.3 ± 1.5 ng/mL in high-risk hypertensives compared with 1.45 ± 0.7 ng/mL in control group (p < 0.001). Median NR2 peptide antibodies level was significantly higher in those patients who sustained an recurrent stroke compared with those who did not (4.2 ± 1.2 ng/mL versus 2.7 ± 1.8 ng/mL, p = 0.003). According to weighted Cox proportional hazard model after adjustment for age, sex, ethnic group the risk of recurrent ischemic stroke at follow-up had increased in hypertensives with baseline NR2 peptide antibodies level ≥ 4.5 ng/mL (HR 1.25; 95% CI, 1.06–1.37) as well as in patients with elevated NR2 antibodies level combined with multifocal brain lesion (HR 4.36; 95% CI, 1.6–12.2) and abnormal circadian blood pressure profile (HR 3.13; 95% CI, 1.1–12.7 respectively).Conclusions:
Serum level of NR2 peptide antibodies may represent a novel biomarker of ischemic stroke recurrence in high risk hypertensive patients.