A Bioclinical Pattern for the Early Diagnosis of Cardioembolic Stroke
Background and Scope. Early etiologic diagnosis of ischemic stroke subtype guides acute management and treatment. We aim to evaluate if plasma biomarkers can predict stroke subtypes in the early phase from stroke onset. Methods. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP),...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2014/242171 |
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| author | Bruno Zecca Clara Mandelli Alberto Maino Chiara Casiraghi Giovanbattista Bolla Dario Consonni Paola Santalucia Giuseppe Torgano |
| author_facet | Bruno Zecca Clara Mandelli Alberto Maino Chiara Casiraghi Giovanbattista Bolla Dario Consonni Paola Santalucia Giuseppe Torgano |
| author_sort | Bruno Zecca |
| collection | DOAJ |
| description | Background and Scope. Early etiologic diagnosis of ischemic stroke subtype guides acute management and treatment. We aim to evaluate if plasma biomarkers can predict stroke subtypes in the early phase from stroke onset. Methods. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP), D-dimer, C-reactive protein, serum albumin, and globulin levels have been investigated in 114 consecutive patients presenting at the emergency room within 6 hours of the ischemic stroke onset. Plasma levels of biomarkers have been correlated with stroke aetiology (based on TOAST criteria) by multivariable logistic regression analysis, adjusted for several covariates. Results. Of the 114 patients, 34 (30%) had cardioembolic stroke, 27 (23%) atherothrombotic stroke, 19 (17%) lacunar stroke, and 34 (30%) stroke of undetermined origin. Patients with cardioembolic stroke had significantly higher levels of NT-proBNP and lower globulin/albumin (G/A) ratio compared with the other subgroups. At multiple logistic regression NT-proBNP>200 pg/mL, G/A ratio>0.70, and NIHSS score were independent predictors of cardioembolic stroke with high accuracy of the model, either including (AUC, 0.91) or excluding (AUC, 0.84) atrial fibrillation. Conclusions. A prediction model that includes NT-proBNP, G/A ratio, and NIHSS score can be useful for the early etiologic diagnosis of ischemic stroke. |
| format | Article |
| id | doaj-art-ac69e83966c941928420cb32456a067b |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-ac69e83966c941928420cb32456a067b2025-02-03T01:02:57ZengWileyEmergency Medicine International2090-28402090-28592014-01-01201410.1155/2014/242171242171A Bioclinical Pattern for the Early Diagnosis of Cardioembolic StrokeBruno Zecca0Clara Mandelli1Alberto Maino2Chiara Casiraghi3Giovanbattista Bolla4Dario Consonni5Paola Santalucia6Giuseppe Torgano7Emergency Care Unit, Fondazione IRCCS Ca’ Granda OspedaleMaggiore Policlinico, Via F. Sforza 35, 20100 Milan, ItalyEmergency Care Unit, Fondazione IRCCS Ca’ Granda OspedaleMaggiore Policlinico, Via F. Sforza 35, 20100 Milan, ItalyUniversità degli Studi di Milano, Via Festa del Perdono 7, 20100 Milan, ItalyEmergency Care Unit, Fondazione IRCCS Ca’ Granda OspedaleMaggiore Policlinico, Via F. Sforza 35, 20100 Milan, ItalyCardiovascular Disease Institute, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20100 Milan, ItalyEpidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20100 Milan, ItalyEmergency Care Unit, Fondazione IRCCS Ca’ Granda OspedaleMaggiore Policlinico, Via F. Sforza 35, 20100 Milan, ItalyEmergency Care Unit, Fondazione IRCCS Ca’ Granda OspedaleMaggiore Policlinico, Via F. Sforza 35, 20100 Milan, ItalyBackground and Scope. Early etiologic diagnosis of ischemic stroke subtype guides acute management and treatment. We aim to evaluate if plasma biomarkers can predict stroke subtypes in the early phase from stroke onset. Methods. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP), D-dimer, C-reactive protein, serum albumin, and globulin levels have been investigated in 114 consecutive patients presenting at the emergency room within 6 hours of the ischemic stroke onset. Plasma levels of biomarkers have been correlated with stroke aetiology (based on TOAST criteria) by multivariable logistic regression analysis, adjusted for several covariates. Results. Of the 114 patients, 34 (30%) had cardioembolic stroke, 27 (23%) atherothrombotic stroke, 19 (17%) lacunar stroke, and 34 (30%) stroke of undetermined origin. Patients with cardioembolic stroke had significantly higher levels of NT-proBNP and lower globulin/albumin (G/A) ratio compared with the other subgroups. At multiple logistic regression NT-proBNP>200 pg/mL, G/A ratio>0.70, and NIHSS score were independent predictors of cardioembolic stroke with high accuracy of the model, either including (AUC, 0.91) or excluding (AUC, 0.84) atrial fibrillation. Conclusions. A prediction model that includes NT-proBNP, G/A ratio, and NIHSS score can be useful for the early etiologic diagnosis of ischemic stroke.http://dx.doi.org/10.1155/2014/242171 |
| spellingShingle | Bruno Zecca Clara Mandelli Alberto Maino Chiara Casiraghi Giovanbattista Bolla Dario Consonni Paola Santalucia Giuseppe Torgano A Bioclinical Pattern for the Early Diagnosis of Cardioembolic Stroke Emergency Medicine International |
| title | A Bioclinical Pattern for the Early Diagnosis of Cardioembolic Stroke |
| title_full | A Bioclinical Pattern for the Early Diagnosis of Cardioembolic Stroke |
| title_fullStr | A Bioclinical Pattern for the Early Diagnosis of Cardioembolic Stroke |
| title_full_unstemmed | A Bioclinical Pattern for the Early Diagnosis of Cardioembolic Stroke |
| title_short | A Bioclinical Pattern for the Early Diagnosis of Cardioembolic Stroke |
| title_sort | bioclinical pattern for the early diagnosis of cardioembolic stroke |
| url | http://dx.doi.org/10.1155/2014/242171 |
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