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Biomarkers. 2018 May - Jun;23(4):392-405. doi: 10.1080/1354750X.2018.1434681. Epub 2018 Feb 12.

Verification of a proteomic biomarker panel to diagnose minor stroke and transient ischaemic attack: phase 1 of SpecTRA, a large scale translational study.

Author information

1
a Neurosciences, Stroke Rapid Assessment Clinic , Island Health Authority , Victoria , BC , Canada.
2
b Department of Research and Capacity Building , Island Health Authority , Victoria , BC , Canada.
3
c Departments of Clinical Neurosciences, Radiology, and Community Health Services , University of Calgary, Hotchkiss Brain Institute, C1242, Foothills Medical Centre , Calgary , AB , Canada.
4
d Department of Mathematics and Statistics , University of Victoria , Victoria , BC , Canada.
5
e British Columbia Centre for Disease Control , Vancouver , BC , Canada.
6
f Division of Medical Sciences , University of Victoria , Victoria , BC , Canada.
7
g University of Victoria - Genome British Columbia Proteomics Centre, Vancouver Island Technology Park , Victoria , BC , Canada.
8
h Department of Medicine , University of Toronto Sunnybrook Health Sciences Centre , Toronto , ON , Canada.
9
i Department of Biochemistry and Microbiology , University of Victoria , Victoria , BC , Canada.
10
j Gerald Bronfman Department of Oncology , Jewish General Hospital McGill University , Montreal , QC , Canada.
11
k Proteomics Centre, Segal Cancer Centre, Lady Davis Institute, Jewish General Hospital, McGill University , Montreal , QC , Canada.

Abstract

OBJECTIVE:

To derive a plasma biomarker protein panel from a list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke from non-cerebrovascular (mimic) conditions in emergency department (ED) settings.

DESIGN:

Prospective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 h following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS).

PARTICIPANTS:

Totally 545 participants suspected of TIA enrolled in the EDs of two urban medical centres.

OUTCOMES:

90-day, neurologist-adjudicated diagnosis of TIA informed by clinical and radiological investigations.

RESULTS:

The final protein panel consists of 16 proteins whose patterns show differential abundance between TIA and mimic patients. Nine of the proteins were significant univariate predictors of TIA [odds ratio (95% confidence interval)]: L-selectin [0.726 (0.596-0.883)]; Insulin-like growth factor-binding protein 3 [0.727 (0.594-0.889)]; Coagulation factor X [0.740 (0.603-0.908)]; Serum paraoxonase/lactonase 3 [0.763 (0.630-0.924)]; Thrombospondin-1 [1.313 (1.081-1.595)]; Hyaluronan-binding protein 2 [0.776 (0.637-0.945)]; Heparin cofactor 2 [0.775 (0.634-0.947)]; Apolipoprotein B-100 [1.249 (1.037-1.503)]; and von Willebrand factor [1.256 (1.034-1.527)]. The scientific plausibility of the panel proteins is discussed.

CONCLUSIONS:

Our panel has the potential to assist ED physicians in distinguishing TIA from mimic patients.

KEYWORDS:

TIA; TIA biomarkers; plasma biomarkers; stroke biomarkers; stroke proteomic; transient ischaemic attack

PMID:
29385837
DOI:
10.1080/1354750X.2018.1434681
[Indexed for MEDLINE]

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