Early Biomarkers of Stroke

Early Biomarkers of Stroke

The diagnosis and management of acute ischemic stroke are limited by the lack of rapid diagnostic assays for use in an emergency setting. Computed tomography (CT) scanning is used to diagnose hemorrhagic stroke but is relatively ineffective (<33% sensitive) in detecting ischemic stroke. The abili...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Vol. 49; no. 10; pp. 1733 - 1739
Main Authors: Reynolds, Mark A, Kirchick, Howard J, Dahlen, Jeffrey R, Anderberg, Joseph M, McPherson, Paul H, Nakamura, Kevin K, Laskowitz, Daniel T, Valkirs, Gunars E, Buechler, Kenneth F
Format: Journal Article
Language:English
Published: England Am Assoc Clin Chem 01-10-2003
Oxford University Press
Subjects:
Acute Disease
Algorithms
Bar codes
Biomarkers
Biomarkers - analysis
Biomarkers - blood
Blood Proteins - analysis
Brain
Brain Ischemia - blood
Brain Ischemia - diagnosis
Brain-Derived Neurotrophic Factor - blood
Chemokine CCL2 - blood
Computed tomography
Emergency medical care
Enzyme-Linked Immunosorbent Assay
Growth factors
Humans
Intracranial Hemorrhages - blood
Intracranial Hemorrhages - diagnosis
Ischemia
Magnetic resonance imaging
Matrix Metalloproteinase 9 - blood
Medical imaging
Multivariate analysis
Nerve Growth Factors
Plasma
Prognosis
Proteins
Regression Analysis
S100 Calcium Binding Protein beta Subunit
S100 Proteins - blood
Sensitivity and Specificity
Stroke
Stroke - blood
Stroke - diagnosis
Tomography
von Willebrand Factor - analysis
Work stations
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Summary:The diagnosis and management of acute ischemic stroke are limited by the lack of rapid diagnostic assays for use in an emergency setting. Computed tomography (CT) scanning is used to diagnose hemorrhagic stroke but is relatively ineffective (<33% sensitive) in detecting ischemic stroke. The ability to correlate blood-borne protein biomarkers with stroke phenotypes would aid in the development of such rapid tests. ELISAs for >50 protein biomarkers were developed for use on a high-throughput robotic workstation. These assays were used to screen plasma samples from 214 healthy donors and 223 patients diagnosed with stroke, including 82 patients diagnosed with acute ischemic stroke. Marker assay values were first compared by univariate analysis, and then the top markers were subjected to multivariate analysis to derive a marker panel algorithm for the prediction of stroke. The top markers from this analysis were S-100b (a marker of astrocytic activation), B-type neurotrophic growth factor, von Willebrand factor, matrix metalloproteinase-9, and monocyte chemotactic protein-1. In a panel algorithm in which three or more marker values above their respective cutoffs were scored as positive, these five markers provided a sensitivity of 92% at 93% specificity for ischemic stroke samples taken within 6 h from symptom onset. A marker panel approach to the diagnosis of stroke may provide a useful adjunct to CT scanning in the emergency setting.
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ISSN:0009-9147
1530-8561
DOI:10.1373/49.10.1733