Biomarker Panels in Ischemic Stroke

Jickling, Glen C.; Sharp, Frank R.

doi:10.1161/strokeaha.114.005604

Cited by 114 publications

(91 citation statements)

References 49 publications

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“…Although clinical factors such as age, sex and stroke severity can stratify risk, a reliable blood‐based biomarker at the time of stroke onset would help identify high‐risk individuals and potentially inform treatment decisions 3. Furthermore, a stroke biomarker that could identify patients at greater risk for secondary ischemic injury, poor functional outcome and mortality would aid in prognosis.…”

Section: Introductionmentioning

confidence: 99%

Soluble ST2 predicts outcome and hemorrhagic transformation after acute stroke

Wolcott

Batra

Bevers

et al. 2017

Ann Clin Transl Neurol

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Objective ST2 is a member of the toll‐like receptor superfamily that can alter inflammatory signaling of helper T‐cells. We investigated whether soluble ST2 (sST2) could independently predict outcome and hemorrhagic transformation (HT) in the setting of stroke.MethodsWe measured sST2 in patients enrolled in the Specialized Program of Translational Research in Acute Stroke (SPOTRIAS) network biomarker study. 646 patients had plasma samples collected at the time of hospital admission and 210 patients had a second sample collected 48 h after stroke onset. Functional outcome was assessed using the modified Rankin Scale (mRS), with good and poor outcomes defined as mRS 0‐2 and 3‐6, respectively. HT was classified using ECASS criteria. The relationships between sST2, outcome, and HT were evaluated using multivariable logistic regression, Kaplan–Meier survival analysis and receiver operating characteristic curves.Results646 patients were included in the analysis (mean age 69 years; 44% women), with a median NIHSS of 5 [IQR: 2–12]. The median sST2 level on hospital admission was 35.0 ng/mL [IQR: 25.7–49.8 ng/mL] and at 48 h it was 37.4 ng/mL [IQR 27.9–55.6 ng/mL]. sST2 was independently associated with poor outcome (OR: 2.77, 95% CI: 1.54–5.06; P = 0.003) and mortality (OR: 3.56, 95% CI: 1.58–8.38, P = 0.001) after multivariable adjustment. Plasma sST2 was also associated with hemorrhagic transformation after adjustment for traditional risk factors (OR: 5.58, 95% CI: 1.40–37.44, P = 0.039).InterpretationSoluble ST2 may serve as a prognostic biomarker for outcome and hemorrhagic transformation in patients with acute stroke. ST2 may link neuroinflammation and secondary injury after stroke.

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Section: Introductionmentioning

confidence: 99%

Soluble ST2 predicts outcome and hemorrhagic transformation after acute stroke

Wolcott

Batra

Bevers

et al. 2017

Ann Clin Transl Neurol

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“…For example, diffusion weight imaging is very sensitive at showing the smallest acute ischaemic lesions, whereas a magnetic resonance angiography is the preferred choice for MRI is often performed as a complement to the follow-up imaging during the Several blood biomarkers and biomarker panels have been studied to improve of these studies has not surpassed clinical judgement nor circumvented the need for imaging in the diagnosis procedure. (Whiteley et al 2008, Jickling & Sharp 2015 Currently, the laboratory exams taken in the ED mainly serve the exclusion criteria for recanalizarion therapies. However, the subject is intensely studied and several hundreds of potential biomarkers are currently being tested (Mattila et al 2016).…”

Section: Score Descriptionmentioning

confidence: 99%

“…Although the use of biomarker panels has proven to be feasible even in a stroke scales (Vanni et al 2011, Jickling et al 2015.…”

Section: Prehospital Recognition Of Acute Strokementioning

confidence: 99%

Stroke and the emergency medical services – enhancing performance within the chain of survival

Puolakka

2017

Acta Anaesthesiol Scand

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“…The leaking blood-brain barrier, hence, enables the circulation between molecular mediators of the inflammatory cerebrospinal fluid (CSF) and the blood system [13,15,17].…”

Section: Impact On Final Aschemic Cerebral Damagementioning

confidence: 99%

Prospective of ischemic stroke biomarkers

Szewczak

Nieśpiałowska

Jakubowska-Solarska

et al. 2017

Current Issues in Pharmacy and Medical Sciences

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Methods currently used in brain vascular disorder diagnostics are neither fast enough nor clear-out; thus, there exists a necessity of finding new types of testing which could enlarge and complete the actual panel of diagnostics or be an alternative to current methods. The discovery of sensitive and specific biomarkers of ischemic brain stroke will improve the effects of treatment and will help to assess the progress or complications of the disease. The relevant diagnosis of ischemic stroke (IS) within the first 4.5 hours after the initial symptoms allows for the initiation of treatment with recombinant tissue plasminogen activators which limits the magnitude of negative changes in the brain and which enhance the final effectiveness of therapy. The potential biomarkers which are under investigation are substances involved in the processes of coagulation and fibrinolysis, and are of molecules released from damaged vascular endothelial cells and from nerves and cardiac tissue. The analyzed substances are typical of oxidative stress, apoptosis, excitotoxicity and damage of the blood brain barrier.

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Biomarker Panels in Ischemic Stroke

Cited by 114 publications

References 49 publications

Soluble ST2 predicts outcome and hemorrhagic transformation after acute stroke

Soluble ST2 predicts outcome and hemorrhagic transformation after acute stroke

Stroke and the emergency medical services – enhancing performance within the chain of survival

Prospective of ischemic stroke biomarkers

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