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A blood-based biomarker panel to detect acute stroke.

Publication ,  Journal Article
Sharma, R; Macy, S; Richardson, K; Lokhnygina, Y; Laskowitz, DT
Published in: J Stroke Cerebrovasc Dis
2014

BACKGROUND: The aim of this study was to develop an adjunctive, peripheral biomarker test to differentiate ischemic strokes, intracranial hemorrhages (ICHs), and stroke mimics in the acute setting. METHODS: Serum samples were collected from 167 patients who presented with an acute neurologic deficit within 24 hours of symptom onset. Patients were adjudicated to ischemic stroke, ICH, and mimic pathology groups based on clinical and radiographic findings. Samples were tested for levels of 262 potential markers. A multivariate Cox proportional hazards regression model of 5 biomarkers was built by stepwise selection and validated by bootstrapping. Its discriminative capacity was quantified by C index and net reclassification improvement (NRI). RESULTS: The final model consisted of eotaxin, epidermal growth factor receptor, S100A12, metalloproteinase inhibitor-4, and prolactin. It demonstrated a discriminative capacity for ischemic stroke versus mimic (C = .92), ischemic stroke and ICH versus mimic (C = .93), and ischemic stroke versus ICH (C = .82). The inclusion of biomarkers to a model consisting of age, race, and gender resulted in an NRI of 161% when detecting ischemic stroke versus mimic (P < .0001), an improvement of 171% when detecting ischemic strokes plus ICH versus mimic (P < .0001), and an improvement of 56% when detecting ischemic strokes versus ICH (P = .1419). CONCLUSIONS: These results suggest that information obtained from a 5-biomarker panel may add valuable information in the early evaluation and management of patients with stroke-like symptoms.

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Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

2014

Volume

23

Issue

5

Start / End Page

910 / 918

Location

United States

Related Subject Headings

  • Tissue Inhibitor of Metalloproteinases
  • Tissue Inhibitor of Metalloproteinase-4
  • Stroke
  • Sex Factors
  • S100 Proteins
  • Risk Factors
  • Reproducibility of Results
  • Racial Groups
  • Proportional Hazards Models
  • Prolactin
 

Citation

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Sharma, R., Macy, S., Richardson, K., Lokhnygina, Y., & Laskowitz, D. T. (2014). A blood-based biomarker panel to detect acute stroke. J Stroke Cerebrovasc Dis, 23(5), 910–918. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.07.034
Sharma, Richa, Stephanie Macy, Kara Richardson, Yuliya Lokhnygina, and Daniel T. Laskowitz. “A blood-based biomarker panel to detect acute stroke.J Stroke Cerebrovasc Dis 23, no. 5 (2014): 910–18. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.07.034.
Sharma R, Macy S, Richardson K, Lokhnygina Y, Laskowitz DT. A blood-based biomarker panel to detect acute stroke. J Stroke Cerebrovasc Dis. 2014;23(5):910–8.
Sharma, Richa, et al. “A blood-based biomarker panel to detect acute stroke.J Stroke Cerebrovasc Dis, vol. 23, no. 5, 2014, pp. 910–18. Pubmed, doi:10.1016/j.jstrokecerebrovasdis.2013.07.034.
Sharma R, Macy S, Richardson K, Lokhnygina Y, Laskowitz DT. A blood-based biomarker panel to detect acute stroke. J Stroke Cerebrovasc Dis. 2014;23(5):910–918.
Journal cover image

Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

2014

Volume

23

Issue

5

Start / End Page

910 / 918

Location

United States

Related Subject Headings

  • Tissue Inhibitor of Metalloproteinases
  • Tissue Inhibitor of Metalloproteinase-4
  • Stroke
  • Sex Factors
  • S100 Proteins
  • Risk Factors
  • Reproducibility of Results
  • Racial Groups
  • Proportional Hazards Models
  • Prolactin