Currently, the lack of widely available diagnostic test for acute cerebral ischemia remains a limitation in the diagnosis (made by clinical and CT scan data in most cases). Despite improvements in the field, yet very few patients benefit from new treatments and many of them never arrive on time to hospitals in which stroke units are ready to administer tPA (only effective within <4.5 hours the onset of symptoms). Therefore, a rapid biochemical diagnosis that would help distinguish the stroke of stroke-mimicking conditions (brain tumours, seizures, migraine ...) and accelerate the process of referral of patients would be of great interest. This would improve neurological recovery of many patients that would receive reperfusion treatments and would save a lot of resources for public health by preventing unnecessary transfers of many patients who are not real strokes to reference hospitals. In fact, the percentage of cases in which the doctor thinks to be in front of a stroke and after the full study at the hospital confirms to be another kind of disease can be really high in some series.
The idea of identifying the "troponins" of stroke has encouraged several academic groups and biotechnology companies to initiate programs of discovery in recent years.
|1N86||D-dimer||D-dimer is a fibrin degradation product. It is increased in acute phase of ischemic stroke and is associated with a high risk of recurrence and with cardioembolic etiology. It has been also associated with poor outcome and mortality. Similar levels have been determined in both subtypes of stroke during acute phase.||Stroke|
|O76038||SEGN||High levels of secretagogin have been found in patients suffering from hypoxic brain injury. Similar levels have been determined in both subtypes of stroke during acute phase.||Mimic|
|P01185||NEU2||Copeptin adds predictive information on functional outcome and mortality at long-term.||Stroke|
|P02741||CRP||Independent of other cardiovascular risk factors, elevated plasma CRP levels significantly predict the risk of future ischemic stroke and TIA in the elderly. In ischemic stroke patients, high CRP circulating levels within 24h from onset are associated with poor long-term functional outcome . No clear association has been found with aetiological classification of ischemic stroke. No diferences at plasma levels between hemorragic and ischemic stroke.||Stroke|
|P02768||ALBU||Baseline Ischemia-Modified Albumin (IMA) blood levels may be a biomarker for early identification of acute stroke, but not to differentiate Ischemic from hemorrhagic stroke patients. On the other hand, serum albumin is decreased in those patients who die following a stroke. No significant association has been found between vWf levels and aetiological subtypes of ischemic stroke. No ignificant difference at plasma level between stroke subtypes.||Stroke|
|P04271||S100B||Higher levels of S100B in ischemic stroke patients than healthy controls, showing a trend to be higher in those patients with poor outcome at third month after stroke. Also, high S100B leves have been associated with hemorrhagic transformation and brain edema. No clear association has been found between S100B levels and aetiological classification of ischemic stroke. Higher plasma levels were found in intracerebral hemorrhage than ischemic stroke patients.||Stroke|
|P09104||ENOG||Similar levels have been determined in both subtypes of stroke during acute phase.||Stroke|
|P14780||MMP9||Associated with BBB disruption. Positively correlated with stroke severity and infart volume within acute phase of ischemic stroke. Raised plasma MMP-9 in stroke patients than mimics. Its relationship with poor outcome is not clear. Similar levels have been determined in both subtypes of stroke during acute phase.||Stroke|
|P16860||ANFB||High circulating levels of BNP/NT-proBNP are associated with poor outcome after stroke, although only minor predictive value is added to clinical information . High BNP levels indicate an embolic origin for stroke patients. Similar levels have been determined in both subtypes of stroke.||Stroke, TIA|
|P22303||ACES||Low cholinesterase activity in stroke patients who will die within 1 year.||Control|
|P42574||CASP3||Downregulation of caspase-3 is associated with reduced brain damage in ischemic models. CASP3 is more elevated in stroke than mimics. Similar levels have been determined in both subtypes of stroke during acute phase.||Stroke|