Blood-based biomarkers are associated with different ischemic stroke mechanisms and enable rapid classification between cardioembolic and atherosclerosis etiologies

Dorin Harpaz, Raymond C.S. Seet, Robert S. Marks, Alfred I.Y. Tok

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Stroke is a top leading cause of death, which occurs due to interference in the blood flow of the brain. Ischemic stroke (blockage) accounts for most cases (87%) and is further subtyped into cardioembolic, atherosclerosis, lacunar, other causes, and cryptogenic strokes. The main value of subtyping ischemic stroke patients is for a better therapeutic decision-making process. The current classification methods are complex and time-consuming (hours to days). Specific blood-based biomarker measurements have promising potential to improve ischemic stroke mechanism classification. Over the past decades, the hypothesis that different blood-based biomarkers are associated with different ischemic stroke mechanisms is increasingly investigated. This review presents the recent studies that investigated blood-based biomarker characteristics differentiation between ischemic stroke mechanisms. Different blood-based biomarkers are specifically discussed (b-type natriuretic peptide, d-dimer, c-reactive protein, tumor necrosis factor-α, interleukin-6, interleukin-1β, neutrophil–lymphocyte ratio, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and apolipoprotein A), as well as the different cut-off values that may be useful in specific classifications for cardioembolic and atherosclerosis etiologies. Lastly, the structure of a point-of-care biosensor device is presented, as a measuring tool on-site. The information presented in this review will hopefully contribute to the major efforts to improve the care for stroke patients.

Original languageEnglish
Article number804
JournalDiagnostics
Volume10
Issue number10
DOIs
StatePublished - 9 Oct 2020

Keywords

  • Blood-based biomarkers
  • Diagnostics
  • Etiology classification
  • Ischemic stroke mechanisms
  • Point-of-care biosensors
  • Statistical analysis

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