Abstract 30: Is NR2 Peptide Promising Biomarker for Acute Cerebrovascular Events?
Introduction: Feasibility studies of NR2 peptide, a cleavage product of NMDA neuroreceptors that released into the bloodstream due to cerebral ischemia were conducted at 8 clinical sites. The following indications were probed: acute IS vs non-stroke, IS vs hemorrhage, risk of TIA/stroke and secondary ischemic events. The diagnostic potential of NR2 peptide assay in emergency, vascular surgery, neurology, and neurosurgery settings is summarized.
Methods: Pilot studies were performed according to protocols approved by Ethic Committees at 7 clinical sites in USA, Germany, and UK. The total of 380 patients with hyper-acute (n=186) and acute hemispheric stroke (n=194), mild TBI (n=356) were enrolled. Controls consisted of age- and gender-matched non-stroke (n=91), vascular risk factors (n=89), and healthy volunteers (n=187) were recruited at KSU. The final diagnosis was determined based on clinical observations and radiological findings (CT, MRI, DWI). Blinded plasma was assayed by rapid magnetic particles (MP) ELISA (30 min). Results for different groups were compared using univariate and multivariate statistical analyses.
Results: When the biomarker cut off was set at 1.0 ng/mL, this resulted in a sensitivity of 92% and a specificity of 96% to detect acute IS within 24 h of onset. In hyper-acute IS, NR2 peptide showed sensitivity of 88% and specificity of 99% (0.5 ng/mL cut off) within 0.5-4.5 h of onset.
Conclusions: The statistical significance of NR2 peptide values in acute IS has been demonstrated with timely corresponding cut off value. The assay might be used in conjunction with neurological assessment and followed up by neuroimaging. The NR2 peptide plasma assay could assist in ruling-out individuals without acute cerebrovascular events. Further studies are needed.
- © 2012 by American Heart Association, Inc.