Multiple Biomarkers for the Prediction of Ischemic Stroke

Prugger, Christof; Luc, Gérald; Haas, Bernadette; Morange, Pierre‐Emmanuel; Ferrières, Jean; Amouyel, Philippe; Kee, Frank; Ducimetière, Pierre; Empana, Jean‐Philippe

doi:10.1161/atvbaha.112.300109

Cited by 67 publications

(58 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Not only is resistin positively associated with severity of coronary artery disease and calcification, but can also independently predict major cardiovascular events, including ischemic stroke and cardiovascular mortality. [28][29][30][31] Herein, as expected, we identified a significant and independent association between increased resistin levels and cerebrovascular symptomatology. However, this relationship was observed only among T2DM subjects.…”

Section: Proatherogenic Actions Of Resistinsupporting

confidence: 86%

Circulating Chemerin Is Associated With Carotid Plaque Instability, Whereas Resistin Is Related to Cerebrovascular Symptomatology

Gasbarrino

Mantzoros

Gorgui

et al. 2016

ATVB

View full text Add to dashboard Cite

Objective— The rupture of unstable carotid atherosclerotic plaques is one of the main causes of cerebrovascular ischemic events. There is need for circulating markers that can predict plaque instability and risk of stroke. Proinflammatory chemerin, leptin, and resistin, along with anti-inflammatory adiponectin, are adipokines with direct influence on vascular function. We investigated the association of circulating adipokines with carotid plaque instability and cerebrovascular symptomatology. Approach and Results— Neurologically symptomatic and asymptomatic patients (n=165) scheduled for carotid endarterectomy were recruited. Fasting blood samples were collected preoperatively; adiponectin and leptin levels were determined by radioimmunoassay; and chemerin and resistin levels were measured by enzyme-linked immunosorbent assays. The instability of plaque specimens was assessed using gold-standard histological classifications. Chemerin was significantly associated with plaque instability. The fully adjusted model, accounting for age, sex, body mass index, high-sensitivity C-reactive protein, type 2 diabetes mellitus, and circulating adiponectin, leptin, and resistin, yielded an odds ratio of 0.991 (95% confidence interval 0.985–0.998) for plaque instability per unit increase in chemerin. High leptin levels were significantly associated with presence of specific features of plaque instability. In subjects with type 2 diabetes mellitus, resistin levels were significantly elevated in symptomatic when compared with asymptomatic subjects ( P =0.001) and increased the risk of cerebrovascular symptomatology (adjusted odds ratio 1.264, 95% confidence interval 1.004–1.594). Conclusions— Low chemerin and high resistin levels were associated with carotid disease severity, suggesting that these adipokines may act as potential markers for plaque instability and stroke risk. Future studies are needed to assess causation between circulating adipokines and plaque instability.

show abstract

Section: Proatherogenic Actions Of Resistinsupporting

confidence: 86%

Circulating Chemerin Is Associated With Carotid Plaque Instability, Whereas Resistin Is Related to Cerebrovascular Symptomatology

Gasbarrino

Mantzoros

Gorgui

et al. 2016

ATVB

View full text Add to dashboard Cite

show abstract

“…Previously, clinical studies have found a negative [9][10][11][12][13][14][15], a positive [16,17], or no association [18][19][20][21][22] between ischaemic stroke and ADP level.…”

Section: Discussionmentioning

confidence: 99%

Czy adiponektyna stanowi czynnik ryzyka występowania napadów przemijającego niedokrwienia mógu/przemijającego niedokrwienia mózgu?

Şener¹,

Uludağ²,

Köse³

et al. 2015

Endokrynologia Polska

View full text Add to dashboard Cite

Adiponectin is an adipocytokine, and it plays a role in atherosclerosis. The role of adiponectin in the development of ischaemic stroke is controversial. Up to now, adiponectin was not evaluated in transient ischaemic stroke. In this study, we investigated the relationship between adiponectin and transient ischaemic attack. Forty patients with transient ischaemic attack were included into the study. In all patients, traditional risk factors of ischaemic stroke and intima-media thickness of carotid arteries were determined. Also, the relationship between these parameters and adiponectin levels were examined. No difference was found in terms of adiponectin levels between patients and healthy subjects. In addition, there was no association between adiponectin levels and traditional risk factors. Our results suggest that adiponectin may not be a predictive risk factor of transient ischaemic attack.

show abstract

“…Measurement of E-selectin and resistin have shown additive value to traditional risk factors [80]. Plasma glial fibrillary acid protein analysis has shown the ability to differentiate intracranial hemorrhage and ischemic stroke within 4.5 h of symptom onset, and point-of-care systems could be useful in the prehospital phase [81].…”

Section: New Developments and Future Conceptsmentioning

confidence: 99%

Prehospital Stroke Care: Limitations of Current Interventions and Focus on New Developments

et al. 2014

View full text Add to dashboard Cite

Background: The global burden of stroke is immense, both in medical and economic terms. With the aging population and the ongoing industrialization of the third world, stroke prevalence is expected to increase and will have a major effect on national health expenditures. Currently, the medical treatment for acute ischemic stroke is limited to intravenous recombinant tissue plasminogen activator (IV r-tPA), but its time dependency leads to low utilization rates in routine clinical practice. Prehospital delay contributes significantly to delayed or missed treatment opportunities in acute stroke. State-of-the-art acute stroke care, starting in the prehospital phase, could thereby reduce the disease burden and its enormous financial costs. Summary: The first part of this review focuses on current education measures for the general public, the emergency medical services (EMS) dispatchers and paramedics. Although much has been expected of these measures to improve stroke care, no major effects on prehospital delay or missed treatment opportunities have been demonstrated over the years. Most interventional studies showed little or no effect on the onset-to-door time, IV r-tPA utilization rates or outcome, except for prenotification of the receiving hospital by the EMS. No data are currently available on the cost-effectiveness of these commonly used measures. In the second part, we discuss new developments for the improvement of prehospital stroke diagnosis and treatment which could open new perspectives in the nearby future. These include the implementation of prehospital telestroke and the deployment of mobile stroke units. These approaches may improve patient care and could serve as a platform for prehospital clinical trials. Other opportunities include the implementation of noninvasive diagnostics (like transcranial ultrasound and blood-borne biomarkers) and the reevaluation of neuroprotective strategies in the prehospital phase. Key Messages: Timely initiation of treatment can effectively reduce the medical and economic burden of stroke and should begin with optimal prehospital stroke care. For this, prehospital telemedicine is a particularly attractive approach because it is a scalable solution that has the potential to rapidly optimize acute stroke care at limited cost.

show abstract

Multiple Biomarkers for the Prediction of Ischemic Stroke

Cited by 67 publications

References 48 publications

Circulating Chemerin Is Associated With Carotid Plaque Instability, Whereas Resistin Is Related to Cerebrovascular Symptomatology

Circulating Chemerin Is Associated With Carotid Plaque Instability, Whereas Resistin Is Related to Cerebrovascular Symptomatology

Czy adiponektyna stanowi czynnik ryzyka występowania napadów przemijającego niedokrwienia mógu/przemijającego niedokrwienia mózgu?

Prehospital Stroke Care: Limitations of Current Interventions and Focus on New Developments

Contact Info

Product

Resources

About