Proteomic and Demographic Comparisons of Recurrent Ischemic Stroke Patients

Rates of recurrent strokes have remained relatively unchanged over the past couple decades, highlighting a need for advancements in secondary prevention of stroke recurrence. This study utilizes the Blood And Clot Thrombectomy Registry And Collaboration (BACTRAC) tissue bank to identify proteomic and demographic differences in recurrent ischemic stroke patients. Blood samples were collected during mechanical thrombectomy of large-vessel occlusion ischemic strokes. Plasma levels for 184 inflammatory and cardiometabolic proteins were measured in systemic blood and intracranial blood from the infarction area. Differences between recurrent and first-stroke patients were analyzed using Fisher's Exact Test for categorical variables and Student's independent samples t tests or Welch's t tests for continuous variables. Proteins were divided into systemic and intracranial proteins, and independent samples t tests were performed with a False Discovery Rate of 5.0%. Significant variables were used in multiple logistic regression. There were 20 patients in the prior stroke group and 121 in the first stroke group. The prior stroke group had a significantly higher percentage of females (80.0% vs 50.4%, p = 0.016) and lower rate of hyperlipidemia comorbidity (10.5% vs 35.5%, p = 0.034). Two systemic proteins were significantly higher in those with a prior stroke: CCL14 and FGF-19. Multiple logistic regression found higher levels of CCL14 and FGF-19 to be predictive of a stroke being recurrent. Along with other demographics, these proteins could provide a predictive model to identify patients with risk of recurrent ischemic strokes. Serum CCL14 and FGF-19 levels are easily accessible biomarkers, making them possible therapeutic targets for recurrent stroke prevention.