Published online before print December 11, 2003, doi: 10.1161/01.STR.0000105927.62344.4C
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2004;35:57.)
© 2004 American Heart Association, Inc.
Original Contributions |
Novel Diagnostic Test for Acute Stroke
From the Department of Medicine (Neurology) (J.R.L., R.B., D.T.L.), Multidisciplinary Neuroprotection Laboratories (J.R.L., D.T.L.), and Department of Anesthesiology (W.D.W., H.P.G., M.F.N., D.T.L.), Duke University Medical Center, Durham, NC.
Correspondence to Daniel T. Laskowitz, MD, Box 2900, Duke University Medical Center, Durham, NC 27710. E-mail danl{at}neuro.duke.edu
Background and Purpose— The absence of a widely available and sensitive diagnostic test for acute cerebral ischemia remains a significant limitation in the diagnosis and management of stroke. The objective of this study was to examine the feasibility of developing a diagnostic panel of blood-borne biochemical markers of cerebral ischemia.
Methods— Serial blood samples were obtained from patients (n=65 with suspected ischemic stroke, n=157 control subjects) presenting to an academic medical center emergency department. We analyzed 26 blood-borne markers believed to play a role in the ischemic cascade and created a 3-variable logistic regression model to predict the clinical diagnosis of stroke, defined as persistent neurological symptoms of cerebral ischemia lasting >24 hours.
Results— Of the 26 blood-borne markers analyzed, univariate logistic analysis revealed that 4 were highly correlated with stroke (P<0.001): a marker of glial activation (S100ß), 2 markers of inflammation (matrix metalloproteinase-9 and vascular cell adhesion molecule), and 1 marker of thrombosis (von Willebrand factor). When the outcome level was set to a cutoff of P=0.1, our logistic model provided a sensitivity and specificity of 90% for predicting stroke.
Conclusions— A panel of blood-borne biochemical markers may be helpful in identifying patients with acute cerebral ischemia who could benefit from urgent care. Such a test may also be helpful in identifying stroke patients in the prehospital setting so that they could be fast-tracked to an institution equipped to care for patients with acute stroke.
Key Words: diagnosis • stroke • stroke assessment
This article has been cited by other articles:
 |
|
 |
|
  C. H. Liu, S. Huang, J. Cui, Y. R. Kim, C. T. Farrar, M. A. Moskowitz, B. R. Rosen, and P. K. Liu MR contrast probes that trace gene transcripts for cerebral ischemia in live animals FASEB J, September 1, 2007; 21(11): 3004 - 3015. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rentzos, G. P. Paraskevas, E. Kapaki, C. Nikolaou, M. Zoga, A. Tsoutsou, A. Rombos, and D. Vassilopoulos Circulating Interleukin-15 in Dementia Disorders J Neuropsychiatry Clin Neurosci, August 1, 2007; 19(3): 318 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. F. Laterza, V. R. Modur, D. L. Crimmins, J. V. Olander, Y. Landt, J.-M. Lee, and J. H. Ladenson Identification of Novel Brain Biomarkers Clin. Chem., September 1, 2006; 52(9): 1713 - 1721. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Bokesch, G. A. Izykenova, J. B. Justice, K. A. Easley, and S. A. Dambinova NMDA Receptor Antibodies Predict Adverse Neurological Outcome After Cardiac Surgery in High-Risk Patients Stroke, June 1, 2006; 37(6): 1432 - 1436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Aragno, R. Mastrocola, C. Medana, F. Restivo, M. G. Catalano, N. Pons, O. Danni, and G. Boccuzzi Up-Regulation of Advanced Glycated Products Receptors in the Brain of Diabetic Rats Is Prevented by Antioxidant Treatment Endocrinology, December 1, 2005; 146(12): 5561 - 5567. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Tomitori, T. Usui, N. Saeki, S. Ueda, H. Kase, K. Nishimura, K. Kashiwagi, and K. Igarashi Polyamine Oxidase and Acrolein as Novel Biochemical Markers for Diagnosis of Cerebral Stroke Stroke, December 1, 2005; 36(12): 2609 - 2613. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Allard, P. R. Burkhard, P. Lescuyer, J. A. Burgess, N. Walter, D. F. Hochstrasser, and J.-C. Sanchez PARK7 and Nucleoside Diphosphate Kinase A as Plasma Markers for the Early Diagnosis of Stroke Clin. Chem., November 1, 2005; 51(11): 2043 - 2051. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Lynch, H. Wang, M. J. McGirt, J. Floyd, A. H. Friedman, A. L. Coon, R. Blessing, M. J. Alexander, C. Graffagnino, D. S. Warner, et al. Simvastatin Reduces Vasospasm After Aneurysmal Subarachnoid Hemorrhage: Results of a Pilot Randomized Clinical Trial Stroke, September 1, 2005; 36(9): 2024 - 2026. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. U. Ko, A. S. Achrol, M. Chopra, M. Saha, D. Gupta, W. S. Smith, R. T. Higashida, and W. L. Young Cerebral Blood Flow Changes after Endovascular Treatment of Cerebrovascular Stenoses AJNR Am. J. Neuroradiol., March 1, 2005; 26(3): 538 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. F. Moore, H. Li, N. Jeffries, V. Wright, R. A. Cooper Jr, A. Elkahloun, M. P. Gelderman, E. Zudaire, G. Blevins, H. Yu, et al. Using Peripheral Blood Mononuclear Cells to Determine a Gene Expression Profile of Acute Ischemic Stroke: A Pilot Investigation Circulation, January 18, 2005; 111(2): 212 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rentzos, M. Michalopoulou, C. Nikolaou, C. Cambouri, A. Rombos, A. Dimitrakopoulos, E. Kapaki, and D. Vassilopoulos Serum Levels of Soluble Intercellular Adhesion Molecule-1 and Soluble Endothelial Leukocyte Adhesion Molecule-1 in Alzheimer's Disease J Geriatr Psychiatry Neurol, December 1, 2004; 17(4): 225 - 231. [Abstract] [PDF]
|
|
|
|
|
|
P. Irimia, E. Martinez-Vila, J. R. Lynch, and D. T. Laskowitz Diagnostic Test for Acute Cerebral Ischemia * Panel of Serum Markers for Rapid Diagnosis of Acute Stroke Stroke, June 1, 2004; 35(6): e140 - e141. [Full Text] [PDF]
|
|