Recent advances in stroke biomarkers - implications for prognosis and treatment

To summarize recent advances in blood-based biomarkers for acute ischemic stroke relevant to diagnosis, etiological assessment, risk prediction, and outcome prognostication, and to outline future directions for clinical implementation.

Novel biomarkers enhance differentiation of ischemic from hemorrhagic stroke and large vessel occlusion detection, optimizing triage via point-of-care testing. Specific biomarkers improve etiological classification and identification of mechanisms like cardioembolic sources and atrial cardiopathy, enabling targeted secondary prevention. Circulating markers stratify risks of vascular recurrence and infections, linking inflammatory, thrombotic, and endothelial pathways. Prognostic biomarkers refine predictions of functional outcomes, mortality, and reperfusion responses.

To translate these promising findings into clinical care and to identify novel molecular targets, standardized sample collection, rigorous external validation, and multiomics/panel integration will be required. In this sense, blood-based-biomarkers have the potential to sustainably improve diagnostics, prognosis and treatment in stroke care.