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Neurochem Int. 2017 Jul;107:11-22. doi: 10.1016/j.neuint.2017.01.005. Epub 2017 Jan 11.

Stroke biomarkers in clinical practice: A critical appraisal.

Author information

1
Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, Department of Medicine, National University Health System, Singapore.
2
Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
3
Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4
Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, Department of Medicine, National University Health System, Singapore. Electronic address: raymond_seet@nuhs.edu.sg.

Abstract

Biomarkers provide critical mechanistic insights to key biologic processes that occur during cerebral ischemia which, when carefully applied, can improve clinical decision-making in acute stroke management. The translation of a blood-based biomarker in ischemic stroke to clinical practice is challenging, in part, due to the complexity of ischemic stroke pathogenesis and the presence of a blood-brain barrier that restricts the release of brain-specific markers into the circulation. The pathologic and clinical aspects of ischemic stroke are described in this review, where a non-exhaustive list of biomarkers that interrogate different aspects of ischemic stroke such as oxidative damage, inflammation, thrombus formation, cardiac function and brain injury are described. The potential roles of these biomarkers are further examined under different clinical scenarios aimed at (1) averting the risk of hemorrhagic transformation, (2) identifying individuals at risk of early neurologic deterioration and malignant infarction, (3) aiding in the diagnosis of ischemic stroke and its differentiation from other stroke mimics, (4) guiding the search for stroke etiology, and (5) assessing stroke risk within the community. Researchers should explore the roles of stroke biomarkers to enhance clinical decision-making that is presently largely based on intuition and subjective reasoning.

KEYWORDS:

Biomarkers; Etiology; Hemorrhagic transformation; Inflammation; Ischemic stroke; Oxidative damage

PMID:
28088349
DOI:
10.1016/j.neuint.2017.01.005
[Indexed for MEDLINE]

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