Blood Biomarkers for the Differentiation of Cardiac Ischemic Stroke Subtypes: A Systematic Review

Area of Science:

• Neurology
• Biomarker Discovery
• Diagnostic Accuracy

Background:

• Blood biomarkers offer a potentially cost-effective diagnostic tool for ischemic stroke, particularly in resource-limited settings.
• Accurate diagnosis and subtype differentiation are crucial for effective ischemic stroke management.

Purpose of the Study:

• To systematically review existing literature on the diagnostic utility of blood-based biomarkers for ischemic stroke.
• To evaluate the ability of biomarkers to diagnose ischemic stroke and differentiate its etiological subtypes.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Cochrane, OVID, Google Scholar) up to December 2017.
• The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was employed to assess the methodological quality of included studies.
• Twenty-six relevant studies were identified and analyzed.

Main Results:

• Several biomarkers were investigated, with B-type natriuretic peptide (BNP) and D-dimer showing some clinical utility.
• Most other biomarkers lacked consistent results for diagnosing ischemic stroke subtypes.
• Significant limitations were noted across studies, including classification issues, sample size, timing, methods, and data analysis.

Conclusions:

• Based on current evidence, the use of blood biomarkers for routine clinical diagnosis of ischemic stroke is not recommended.
• BNP and D-dimer show potential but require validation through large, well-designed studies for differentiating ischemic stroke subtypes.