Verification of a proteomic biomarker panel to diagnose minor stroke and transient ischaemic attack: phase 1 of SpecTRA, a large scale translational study

• Published in: Biomarkers Vol. 23; no. 4; pp. 392 - 405
• Main Authors: Penn, Andrew M., Bibok, Maximilian B., Saly, Viera K., Coutts, Shelagh B., Lesperance, Mary L., Balshaw, Robert F., Votova, Kristine, Croteau, Nicole S., Trivedi, Anurag, Jackson, Angela M., Hegedus, Janka, Klourfeld, Evgenia, Yu, Amy Y. X., Zerna, Charlotte, Borchers, Christoph H.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 19-05-2018
• Subjects: plasma biomarkers; stroke biomarkers; stroke proteomic; TIA; TIA biomarkers; transient ischaemic attack; stroke proteomic; plasma biomarkers; transient ischaemic attack; TIA; TIA biomarkers; stroke biomarkers
• ISSN: 1354-750X; 1366-5804
• DOI: 10.1080/1354750X.2018.1434681

Objective: To derive a plasma biomarker protein panel from a list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke from non-cerebrovascular (mimic) conditions in emergency department (ED) settings.
Design: Prospective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 h following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS).
Participants: Totally 545 participants suspected of TIA enrolled in the EDs of two urban medical centres.
Outcomes: 90-day, neurologist-adjudicated diagnosis of TIA informed by clinical and radiological investigations.
Results: The final protein panel consists of 16 proteins whose patterns show differential abundance between TIA and mimic patients. Nine of the proteins were significant univariate predictors of TIA [odds ratio (95% confidence interval)]: L-selectin [0.726 (0.596-0.883)]; Insulin-like growth factor-binding protein 3 [0.727 (0.594-0.889)]; Coagulation factor X [0.740 (0.603-0.908)]; Serum paraoxonase/lactonase 3 [0.763 (0.630-0.924)]; Thrombospondin-1 [1.313 (1.081-1.595)]; Hyaluronan-binding protein 2 [0.776 (0.637-0.945)]; Heparin cofactor 2 [0.775 (0.634-0.947)]; Apolipoprotein B-100 [1.249 (1.037-1.503)]; and von Willebrand factor [1.256 (1.034-1.527)]. The scientific plausibility of the panel proteins is discussed.
Conclusions: Our panel has the potential to assist ED physicians in distinguishing TIA from mimic patients.