Biomarkers for Early Detection of Stroke: A Systematic Review

Stroke remains a leading cause of mortality and disability worldwide. Identifying reliable biomarkers for stroke diagnosis and risk prediction could significantly improve patient outcomes through earlier intervention and better risk management. The objective of this systematic review is to systematically review recent studies investigating biomarkers for stroke diagnosis and risk prediction and to synthesize the most promising findings. We conducted a systematic review of 10 studies published between 2008 and 2023 that examined various biomarkers in relation to stroke. Studies were evaluated for quality using a simplified version of the Mixed Methods Appraisal Tool. The reviewed studies investigated a diverse array of biomarkers, including lipids, inflammatory markers, hemodynamic markers, microRNAs, metabolites, and neurodegenerative markers. Key findings include the following: (1) non-traditional lipid markers such as triglycerides and non-high-density lipoprotein cholesterol may be more predictive of stroke risk than low-density lipoprotein; (2) inflammatory markers, particularly IL-6, showed strong associations with stroke risk; (3) hemodynamic markers like midregional proatrial natriuretic peptide (MRproANP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) demonstrated potential in distinguishing stroke subtypes; (4) specific microRNAs (miR-125a-5p, miR-125b-5p, miR-143-3p) were upregulated in acute ischemic stroke; (5) metabolomic studies identified novel markers such as tetradecanedioate and hexadecanedioate associated with cardioembolic stroke; (6) neurodegenerative markers (total-tau, neurofilament light chain) were linked to increased stroke risk. This review highlights the potential of various biomarkers in improving stroke diagnosis and risk prediction. While individual markers show promise, a multi-marker approach combined with clinical variables appears most likely to yield clinically useful tools. Further large-scale validation studies are needed before these biomarkers can be implemented in routine clinical practice.