Background
Blood biomarkers for ischemic and hemorrhagic stroke diagnosis remain elusive. Recent
investigations suggested that apolipoprotein (Apo), matrix metalloproteinase (MMP),
and paraoxonase-1 may be associated with stroke. We hypothesized that Apo A-I, Apo
C-I, Apo C-III, MMP-3, MMP-9, and paraoxonase-1 are differentially expressed in ischemic
stroke, hemorrhagic stroke, and controls.
Methods
In a single-center prospective observational study, consecutive stroke cases were
enrolled if blood samples were obtainable within 12 hours of symptom onset. Age- (±5
years), race-, and sex-matched controls were recruited. Multiplex assays were used
to measure protein levels. The Wilcoxon signed-rank test and the Mann–Whitney U-test were used to compare biomarker values between ischemic stroke patients and controls,
hemorrhagic stroke patients and controls, and ischemic and hemorrhagic stroke patients.
The 95% confidence intervals (CIs) for the difference of 2 medians were calculated.
Results
Fourteen ischemic stroke case–control pairs and 23 intracerebral hemorrhage (ICH)
case–control pairs were enrolled. Median Apo A-I levels were lower in ischemic stroke
cases versus controls (140 mg/dL versus 175 mg/dL, difference of 35 mg/dL, 95% CI
−54 to −16) and in ischemic stroke versus ICH cases (140 mg/dL versus 180 mg/dL, difference
of 40 mg/dL, 95% CI −57 to −23). Median paraoxonase-1 was lower in ischemic stroke
cases than in both ICH cases and matched controls. Median Apo C-I was slightly lower
in ischemic stroke cases than in ICH cases. There were no differences between groups
for MMP-3, MMP-9, and Apo C-III.
Conclusion
Apo A-I and paraoxonase-1 levels may be clinically useful for ischemic stroke diagnosis
and for differentiating between ischemic and hemorrhagic strokes.
Key Words
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Article info
Publication history
Published online: March 16, 2016
Accepted:
February 19,
2016
Received in revised form:
December 23,
2015
Received:
November 4,
2015
Footnotes
Financial support: This work was supported by (1) an institutional Clinical and Translational Science Award, NIH/NCRR Grant Number 8UL1-TR000077, and (2) a grant for resident physician research from the Department of Emergency Medicine, University of Cincinnati.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.027
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
