Biomarkers and mortality after transient ischemic attack and minor ischemic stroke: population-based study

Area of Science:

• Biomarker discovery
• Cardiovascular research
• Oncology research

Background:

• Premature death post-TIA/stroke often stems from cardiac disease or cancer, not recurrent stroke.
• Previous research indicated biomarkers' limited predictive value for nonfatal stroke but potential for all-cause mortality.
• This study explores biomarkers' association with all-cause, cardiac, and cancer death, aiming to explain prior findings.

Purpose of the Study:

• To validate associations between a panel of blood biomarkers and all-cause mortality after TIA or stroke.
• To investigate the predictive value of these biomarkers for cardiac and cancer-specific deaths.
• To assess if biomarkers predict nonfatal vascular events.

Main Methods:

• A population-based cohort (Oxford Vascular Study) of 929 patients was recruited between 2002-2013.
• Fifteen biomarkers were measured, and Cox regression analysis was used to determine associations.
• Model discrimination was evaluated using c-statistic and integrated discrimination improvement.

Main Results:

• No biomarkers predicted nonfatal vascular events.
• Four biomarkers—soluble tumor necrosis factor α receptor-1, von Willebrand factor, heart-type fatty-acid-binding protein, and N-terminal pro-B-type natriuretic peptide—independently predicted all-cause death.
• N-terminal pro-B-type natriuretic peptide was most predictive of vascular death, while heart-type fatty-acid-binding protein predicted cancer deaths. Associations were strongest in patients without prior cardiac disease or cancer.

Conclusions:

• Several biomarkers predict all-cause mortality following TIA and minor stroke.
• N-terminal pro-B-type natriuretic peptide and heart-type fatty-acid-binding protein show potential for guiding screening for occult cardiac disease and cancer.
• Further validation studies are necessary to confirm these findings.