Biomarkers of Acute Stroke Etiology (BASE) Study Methodology

Abstract

Acute ischemic stroke affects over 800,000 US adults annually, with hundreds of thousands more experiencing a transient ischemic attack. Emergent evaluation, prompt acute treatment, and identification of stroke or TIA (transient ischemic attack) etiology for specific secondary prevention are critical for decreasing further morbidity and mortality of cerebrovascular disease. The Biomarkers of Acute Stroke Etiology (BASE) study is a multicenter observational study to identify serum markers defining the etiology of acute ischemic stroke. Observational trial of patients presenting to the hospital within 24 h of stroke onset. Blood samples are collected at arrival, 24, and 48 h later, and RNA gene expression is utilized to identify stroke etiology marker candidates. The BASE study began January 2014. At the time of writing, there are 22 recruiting sites. Enrollment is ongoing, expected to hit 1000 patients by March 2017. The BASE study could potentially aid in focusing the initial diagnostic evaluation to determine stroke etiology, with more rapidly initiated targeted evaluations and secondary prevention strategies.Clinical Trial Registration Clinicaltrials.gov NCT02014896 https://clinicaltrials.gov/ct2/show/NCT02014896?term=biomarkers+of+acute+stroke+etiology&rank=1

Biomarker Application for Precision Medicine in Stroke

“…Confounders affect the signal-to-noise ratio and thus the sensitivity, specificity, and predictive value of the biomarker [7,8]. It is more likely that multiple biomarkers or panels from "Big Data" could improve precision [8,[12][13][14][15][16]. Big Data in stroke effectively aids in the identification of relevant biomarkers from the myriad possibilities [17].…”

Circular RNA expression profile in blood according to ischemic stroke etiology

“…Therefore, there is an increasing need for biomarkers capable of identifying stroke etiology in clinical practice. In recent years, numerous studies have investigated a large amount of new blood biomarkers in relation with stroke etiology [3][4][5][6][7]. However, low sensitivity and specificity of the target biomarkers difficult their translation into clinical practice.…”

Plasma Unesterified Fatty‐Acid Profile Is Dramatically and Acutely Changed under Ischemic Stroke in the Mouse Model

“…Many other brain-specific proteins studied have similar limitations (Ahmad et al, 2012; Fassbender et al, 1997; Kövesdi et al, 2010; Wunderlich et al, 2006), while proteins such as copeptin found elevated under acute stroke conditions are highly non-specific for the brain and may serve as a more general marker of physiologic stress (Katan et al, 2009; Nickel et al, 2012). Another promising approach is utilization of blood gene expression analysis to identify the etiology of acute ischemic stroke (Jauch et al, 2017). However, the timing of RNA expression that requires blood collection 24 hours after stroke onset (Jauch et al, 2017) may add limitations to this approach to meet “the ideal ischemic stroke biomarker” requirements.…”

“…Another promising approach is utilization of blood gene expression analysis to identify the etiology of acute ischemic stroke (Jauch et al, 2017). However, the timing of RNA expression that requires blood collection 24 hours after stroke onset (Jauch et al, 2017) may add limitations to this approach to meet “the ideal ischemic stroke biomarker” requirements.…”