Blood-Based Biomarkers: A Forgotten Friend of Hyperacute Ischemic Stroke

Abstract

Ischemic stroke (IS) is the second leading cause of death worldwide. Multimodal neuroimaging techniques that have significantly facilitated the diagnosis of hyperacute IS are not widely used in underdeveloped areas and community hospitals owing to drawbacks such as high cost and lack of trained operators. Moreover, these methods do not have sufficient resolution to detect changes in the brain at the cellular and molecular levels after IS onset. In contrast, blood-based biomarkers can reflect molecular and biochemical alterations in both normal and pathophysiologic processes including angiogenesis, metabolism, inflammation, oxidative stress, coagulation, thrombosis, glial activation, and neuronal and vascular injury, and can thus provide information complementary to findings from routine examinations and neuroimaging that is useful for diagnosis. In this review, we summarize the current state of knowledge on blood-based biomarkers of hyperacute IS including those associated with neuronal injury, glial activation, inflammation and oxidative stress, vascular injury and angiogenesis, coagulation and thrombosis, and metabolism as well as genetic and genomic biomarkers. Meanwhile, the blood sampling time of the biomarkers which are cited and summarized in the review is within 6 h after the onset of IS. Additionally, we also discuss the diagnostic and prognostic value of blood-based biomarkers in stroke patients, and future directions for their clinical application and development.

Optimizing Accuracy of Stroke Prediction Using Logistic Regression

“…Logistic regression was applied to categorize stroke peril levels. The test outcomes of [19] with logistic regression demonstrated that the enhancing approach accomplished 0.79% Kaggle dataset was also used in the research [20]. The scrutiny work proposes the adoption of different machine learning algorithms.…”

Secondary neurodegeneration following Stroke: what can blood biomarkers tell us?

“…Instead, blood-based biomarkers can reflect molecular and biochemical state in both normal and pathophysiologic processes, including neuronal and vascular injury, inflammation, oxidative stress, glial activation, etc. (70). Since stroke may induce blood brain barrier dysfunction (71), a progressive cross of brain-derived proteins into the bloodstream, and vice versa, may induce changes in concentration of several molecules and, accordingly, affect their clinical value.…”

Plasma Glial Fibrillary Acidic Protein and N-Terminal Pro B-Type Natriuretic Peptide: Potential Biomarkers to Differentiate Ischemic and Hemorrhagic Stroke

“…Stoke remains the second leading cause of death worldwide [1], with Asia accounting for approximately two-thirds of the total mortality [2]. In Korea, the age-standardized prevalence, incidence, and mortality rates of stroke are 1.37%, 232 per 100,000 person years, and 29.6 per 100,000 population, respectively, according to a recent publication [3].…”

“…Unfortunately, treatment options for acute stoke remains limited, and their efficacy depends on the time between symptom onset and treatment. The two main subtypes of stroke are ischemic stroke (IS) (approximately 85% of all strokes) and hemorrhagic stroke (HS) (remaining 15%) [2], the latter comprising intracerebral hemorrhage (ICH) and subarachnoid hemorrhage. To date, no acute treatment has demonstrated clinical efficacy for ICH; however, early management of patients with acute IS with intravenous thrombolysis or mechanical thrombectomy has proven clinical efficacy.…”