1. Combination of blood biomarkers and stroke scales improves identification of large vessel occlusions
- Author
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Shashank Shekhar, Sheila Graham, Barbara Nogueira, Philip Sloan, Toby Gropen, Edoardo Gaude, Joshua D. Bernstock, Sarah E. Smith, Lisa Shaw, Sara Graziadio, Christopher Price, Gonzalo Ladreda Mochales, and Marcos Ladreda Mochales
- Subjects
medicine.medical_specialty ,business.industry ,Stroke severity ,Large vessel ,Plasma levels ,medicine.disease ,ADAMTS13 ,Blood biomarkers ,Internal medicine ,Cohort ,Cardiology ,medicine ,Suspected stroke ,business ,Stroke - Abstract
Background and PurposeAcute ischemic stroke caused by large vessel occlusions (LVO) is a major contributor to stroke deaths and disabilities; however, identification for emergency treatment is challenging.AimsTo evaluate the diagnostic accuracy of a panel of biomarkers for LVO prediction.Methods170 patients with suspected stroke were recruited retrospectively at one hospital. We analysed the plasma levels of D-dimer, OPN, OPG, GFAP, vWF, and ADAMTS13 in LVO vs non-LVO. Diagnostic performance was estimated by using blood biomarkers alone or in combination with NIHSS-derived stroke severity scales.ResultsOur patient cohort comprised 20% stroke mimics, 11% transient ischemic attack, 11% hemorrhagic stroke, 15% LVO ischemic stroke, 28% non-LVO ischemic stroke, and 15% ischemic stroke with unknown LVO status. Multivariable analysis found that the optimal set of blood biomarkers for LVO prediction was D-dimer (OR 15.4, 95% CI 4.9 to 57.6; p-valueConclusionsThe combination of D-dimer, GFAP, and stroke scales could provide a simple and highly accurate tool for identifying LVO patients.
- Published
- 2021