Abstract TP226: Association Of Alpha2-macroglobulin As A Novel Biomarker With Acute Ischemic Stroke
Background: We have identified alpha2-macroglobulin as an acute stroke biomarker by using proteomic technologies with two-dimensional gel electrophoresis (2D-PAGE) and liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Alpha2-macroglobulin is known as a protease inhibitor, which enhance procoagulant properties by the neutralization of plasmin, plasminogen activators and metalloproteinases. The objective of this study was to evaluate the usefulness of serum alpha2-macroglobulin levels in acute ischemic stroke patients.
Methods: Patients with acute ischemic stroke (n=159; 93 male and 66 female, 71.6±10.3 years) and patients with no previous stroke (n=77; 38 male and 39 female, 70.7±9.5 years) were consecutively enrolled in this study. Stroke subtype was evaluated based on the TOAST classification. Serum alpha2-macroglobulin levels were measured by nephelometry.
Results: Serum alpha2-macroglobulin levels at admission in patients with acute ischemic stroke was higher than that in control patients (230.2±5.4 vs. 205.0±7.8 mg/dl, P=0.009). Higher age and white matter lesions by using Fazekas classification were significantly associated with high serum alpha2-macroglobulin levels (P=0.001 and P=0.005). After multivariate logistic regression analysis with sex, age, hypertension, diabetes mellitus, dyslipidemia, and atrial fibrillation, the highest quartile of serum alpha2-macroglobulin levels was independently associated with acute ischemic stroke (OR 1.52, 95% CI 1.13-2.08, P=0.005).
Conclusion: Alpha2-macroglobulin, which was identified by using proteomics, was associated with higher age and white matter lesions. Additionally, serum alpha2-macroglobulin levels was associated with acute ischemic stroke independently from the other factors. Increased alpha2-macroglobulin may be involved in pathophysiology of acute ischemic stroke.
- © 2012 by American Heart Association, Inc.