Study Evaluates Clinical Value of Stroke Biomarkers

Admission glucose level appears to be a strong predictor of poor outcomes

FRIDAY, Feb. 17 (HealthDay News) -- While 136 different stroke biomarkers have been identified, the clinical value of these biomarkers remains unclear, according to a study published online Feb. 9 in the British Journal of Clinical Pharmacology.

Nazeeha Hasan, of the Imperial College in London, and colleagues conducted a systematic review of 141 relevant studies to identify diagnostic and prognostic biomarkers in acute ischemic and hemorrhagic stroke and to find those likely to predict complications following thrombolysis.

The researchers found that three markers -- C-reactive protein, P-selectin, and homocysteine -- significantly differentiated between ischemic stroke patients and healthy controls. Levels of glial fibrillary acidic protein differed significantly between hemorrhagic stroke and ischemic stroke patients (mean difference [MD], 224.58 ng/L). High levels of glucose at admission were a strong predictor of poor prognosis after ischemic stroke and symptomatic intracerebral hemorrhage post-thrombolysis. In addition, glutamate was found to be a significant indicator of progressive (unstable) stroke (MD, 172.65 µmol/L); D-dimer significantly predicted in-hospital death (MD, 0.67 µg/mL); and high fibrinogen levels were significantly associated with poor outcome at three months following ischemic stroke (MD, 47.90 mg/L).

"Few biomarkers currently investigated have meaningful clinical value. Admission glucose may be a strong marker of poor prognosis following acute thrombolytic treatment," the authors write.

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