Novel diagnostic test for acute stroke.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Lynch, JR; Blessing, R; White, WD; Grocott, HP; Newman, MF; Laskowitz, DT

Published Date

  • January 2004

Published In

Volume / Issue

  • 35 / 1

Start / End Page

  • 57 - 63

PubMed ID

  • 14671250

Pubmed Central ID

  • 14671250

Electronic International Standard Serial Number (EISSN)

  • 1524-4628

Digital Object Identifier (DOI)

  • 10.1161/01.STR.0000105927.62344.4C

Language

  • eng

Conference Location

  • United States