Abstract:
BACKGROUND AND PURPOSE:The absence of a widely available and sensitive diagnostic test for acute cerebral ischemia remains a significant limitation in the diagnosis and management of stroke. The objective of this study was to examine the feasibility of developing a diagnostic panel of blood-borne biochemical markers of cerebral ischemia. METHODS:Serial blood samples were obtained from patients (n=65 with suspected ischemic stroke, n=157 control subjects) presenting to an academic medical center emergency department. We analyzed 26 blood-borne markers believed to play a role in the ischemic cascade and created a 3-variable logistic regression model to predict the clinical diagnosis of stroke, defined as persistent neurological symptoms of cerebral ischemia lasting >24 hours. RESULTS:Of the 26 blood-borne markers analyzed, univariate logistic analysis revealed that 4 were highly correlated with stroke (P<0.001): a marker of glial activation (S100beta), 2 markers of inflammation (matrix metalloproteinase-9 and vascular cell adhesion molecule), and 1 marker of thrombosis (von Willebrand factor). When the outcome level was set to a cutoff of P=0.1, our logistic model provided a sensitivity and specificity of 90% for predicting stroke. CONCLUSIONS:A panel of blood-borne biochemical markers may be helpful in identifying patients with acute cerebral ischemia who could benefit from urgent care. Such a test may also be helpful in identifying stroke patients in the prehospital setting so that they could be fast-tracked to an institution equipped to care for patients with acute stroke.
journal_name
Strokejournal_title
Strokeauthors
Lynch JR,Blessing R,White WD,Grocott HP,Newman MF,Laskowitz DTdoi
10.1161/01.STR.0000105927.62344.4Csubject
Has Abstractpub_date
2004-01-01 00:00:00pages
57-63issue
1eissn
0039-2499issn
1524-4628pii
01.STR.0000105927.62344.4Cjournal_volume
35pub_type
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