Second, because rather restrictive inclusion criteria were design

Second, because rather restrictive inclusion criteria were designed in the current study, some critical patients were excluded at the initial enrollment period. Thus, the 90-day mortality rate was relatively low Tipifarnib leukemia in the current study. Therefore, the impact of EPO therapy on 90-day mortality could not be assessed. Finally, although a statistically significant relationship between EPO therapy and a reduction in the incidence of 90-day recurrent stroke was noted in the current investigation, this study did not give cutoff and define positive and negative predictive values as well as provide sensitivities and specificities of EPO on clinical outcome because this study was not actually designed to perform a prognostic study.

ConclusionsEPO therapy significantly increased circulating EPC levels and was strongly associated with favorable 90-day clinical outcomes after IS. The results of this study, therefore, may encourage the application of EPO treatment in patients unsuitable for thrombolytic therapy after acute IS.Key messages? EPO therapy in acute phase of IS was associated with an increase in circulating levels of EPCs at the convalescent phase of IS.? EPO therapy was significantly associated with a reduction in the incidence of 90-day recurrent stroke.? EPO therapy and increased circulating EPC (E3) levels were significantly and independently predictive of decreased 90-day MANE.

AbbreviationsACEI: angiotensin converting enzyme inhibitors; ADC: apparent diffusion coefficient; ARB: angiotensin II type I receptor blockers; DBP: diastolic blood pressure; ECCA: extra-cranial carotid artery; EPC: endothelial progenitor cell; EPO: erythropoietin; FITC: fluorescein isothiocyanate; HDL: high-density lipoprotein; IS: ischemic stroke; KDR: kinase insert domain-conjugating receptor; LDL: low-density lipoprotein; MANE: major adverse neurological event; MNC: mononuclear cell; MRI: Magnetic Resonance Imaging; NIHSS: National Institutes of Health Stroke Scale; PBS: phosphate buffered saline; PE: phycoerythrin; RBC: red blood cell; SBP: systolic blood pressure; tPA: tissue plasminogen activator; WBC: white blood cell.Competing interestsThe authors declare that they have no competing interests.Authors’ contributionsHKY and THT designed the experiment, drafted and performed laboratory work. CKS and SL were responsible for the laboratory assay and troubleshooting.

HSL, SFC, AV-951 CMY, TYT and MYL supervised clinical aspects and participated in patient recruitment. CWL and CHL participated in neurological function assessment. WNC and HKY participated in refinement of experiment protocol and coordination and helped in drafting the manuscript. All authors have read and approved the final manuscript.NotesSee related commentary by Minnerup et al., http://ccforum.com/content/15/2/129 and see related letter by Yuen et al., http://ccforum.

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