Precision medicine in secondary prevention of ischemic stroke: how may blood-based biomarkers help in clinical routine? An expert opinion

Abstract

Purpose of reviewOne in eight patients unfortunately suffers a new stroke within 5 years of their first stroke, even today. Research in precision medicine could lead to a more individualized treatment allocation, possibly achieving lower recurrence rates of ischemic stroke. In this narrative review, we aim to discuss potential clinical implementation of several promising candidate blood biomarkers. Recent findingsWe discuss specifically some promising blood-based biomarkers, which may improve the identification of underlying causes as well as risk stratification of patients according to their specific cerebrovascular risk factor pattern. SummaryMultimodal profiling of ischemic stroke patients by means of blood biomarkers, in addition to established clinical and neuroradiological data, may allow in the future a refinement of decision algorithms for treatment allocation in secondary ischemic stroke prevention.

A novel biomarker panel index improves risk stratification after ischemic stroke

“…A plethora of literature exists on single biomarkers and their ability to predict mortality, or functional disability. 2–4 The interest increasingly shifts from studying one biomarker to studying biomarker panels which accumulate the information of various biomarkers into one score representing the heterogeneity of a disease. One recent study with 3405 patients showed a higher risk for death at 3 months after stroke if five combined biomarkers were elevated (high-sensitivity C-reactive protein, matrix metalloproteinase-9 (MMP-9), complement C3, antiphosphatidylserine antibodies, hepatocyte growth factor) adjusted for clinical covariates (OR 5.67, 95% CI: 1.09–29.52).…”

“…A plethora of literature exists on single biomarkers and their ability to predict mortality, or functional disability. [2][3][4] The interest increasingly shifts from studying one OR for the BPI corresponds to an increase per unit of the index. biomarker to studying biomarker panels which accumulate the information of various biomarkers into one score representing the heterogeneity of a disease.…”

“…A plethora of literature exists on single biomarkers and their ability to predict mortality or functional disability in ischemic stroke. 2–4…”

“…A plethora of literature exists on single biomarkers and their ability to predict mortality or functional disability in ischemic stroke. [2][3][4] Recently, interest has grown into establishing biomarker panels to help accumulate the informative value of various biomarkers into one score. A combination of biomarkers may be superior to a single biomarker as it may reflect different pathophysiological processes.…”

|Therapeutic and preventive effects of apigenin in cerebral ischemia: a review

“…45 Unfortunately, one in eight patients can have another stroke within 5 years of their first stroke due to the negligence in prevention, and recurrent strokes are often more severe than the first. 66 Therefore, prevention of stroke is more important than the treatment. The Mediterranean diet is one of the most respected diets for excellent stroke prevention effects due to the richness in fiber, flavonoids and antioxidants.…”