Blood Biomarkers for Stroke Diagnosis and Management

Neuromolecular Med. 2019 Dec;21(4):344-368. doi: 10.1007/s12017-019-08530-0. Epub 2019 Mar 4.

Abstract

Biomarkers are objective indicators used to assess normal or pathological processes, evaluate responses to treatment and predict outcomes. Many blood biomarkers already guide decision-making in clinical practice. In stroke, the number of candidate biomarkers is constantly increasing. These biomarkers include proteins, ribonucleic acids, lipids or metabolites. Although biomarkers have the potential to improve the diagnosis and the management of patients with stroke, there is currently no marker that has demonstrated sufficient sensitivity, specificity, rapidity, precision, and cost-effectiveness to be used in the routine management of stroke, thus highlighting the need for additional work. A better standardization of clinical, laboratory and statistical procedures between centers is indispensable to optimize biomarker performance. This review focuses on blood biomarkers that have shown promise for translation into clinical practice and describes some newly reported markers that could add to routine stroke care. Avenues for the discovery of new stroke biomarkers and future research are discussed. The description of the biomarkers is organized according to their expected application in clinical practice: diagnosis, treatment decision, and outcome prediction.

Keywords: Biomarker; Diagnosis; Genomics; Management; Proteomics; Stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / blood*
  • Blood Proteins / analysis
  • Cerebral Hemorrhage / diagnosis
  • Diagnosis, Differential
  • Disease Management
  • Glutamic Acid / blood
  • Humans
  • Ischemic Stroke / diagnosis
  • Lipids / blood
  • Nitric Oxide / blood
  • Prognosis
  • RNA / blood
  • Secondary Prevention
  • Stroke / blood*
  • Stroke / diagnosis
  • Stroke / etiology
  • Stroke / therapy
  • Stroke, Lacunar / diagnosis
  • Thrombolytic Therapy
  • Transcriptome
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Proteins
  • Lipids
  • Nitric Oxide
  • Glutamic Acid
  • RNA