Cardio embolic stroke and blood biomarkers: diagnosis and predictors of short-term outcome

• Main Authors: Wafaa S. Mohamed, Elhady A. Abd ElGawad, Amal SE. ElMotayam, Sabah E. Fathy
• Format: Article
• Language: English
• Published: SpringerOpen 2019-10-01
• Series: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
• Subjects: Cardio-embolic stroke; Biomarkers; Brain natriuretic peptide; D-dimer; Creatine kinase; MB
• Online Access: http://link.springer.com/article/10.1186/s41983-019-0102-y

Abstract Background The brain is a productive source of a variety of enzymes and any brain injury like a stroke to brain tissue could similarly result in an increase in these enzymes in cerebrospinal fluid and serum. Evaluation of these enzymes represents a simple method for the ischemic stroke subtype diagnosis and prognosis. Objective: This study aimed to determine the role of brain natriuretic peptide (BNP), d-dimer, creatine–kinase-MB (CK-MB), C-reactive protein (CRP) serum levels, and globulin/albumin ratio in the diagnosis of CES stroke and its ability to predict short-term outcome. Methods This study was conducted on 96 patients with acute ischemic stroke, subdivided into two groups: group Ι was 48 patients with cardio-embolic stroke and group ΙΙ was 48 patients with non-cardio-embolic. All patients were subjected to the assessment of serum BNP, d-dimer and CK-MB, and CRP and globulin/albumin ratio within the first 24 h of stroke. In the third week, they were assessed by mRS. Results The mean levels of BNP, d-dimer level, and CK-MB were significantly higher in patients with cardio-embolic stroke than in patients with non-cardio-embolic stroke (P < 0.001) and also were associated with poor short-term outcome. Conclusion Elevated plasma levels of BNP, d-dimer levels, and CK-MB can be used as surrogate biomarkers for the diagnosis of cardio-embolic stroke and prediction of poor short-term outcomes.