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High levels of four biomarkers may indicate increased risk for stroke
New research suggests adults with high levels of four biomarkers may be at increased risk for stroke.
“Identifying people who are at risk for stroke can help us determine who would benefit most from existing or new therapies to prevent stroke,” Ashkan Shoamanesh, MD, of McMaster University in Hamilton, Ontario, Canada, and a member of the American Academy of Neurology, said in a press release. “Future research could also investigate whether lowering levels of these biomarkers or blocking their action could be a way to prevent strokes.”
Shoamanesh and colleagues added 15 circulating inflammatory biomarkers to the Framingham stroke risk profile score to see whether they refined the score’s predictive ability in 3,224 participants (mean age, 61 years; 54% women) from the Framingham Offspring Study. The primary outcome was incident ischemic stroke between examination 7 and Dec. 31, 2010.
In the primary model adjusted for age and sex, In-C-reactive protein (In-CRP; HR = 1.28; 95% CI 1.04-1.56), In-tumor necrosis factor receptor 2 (HR = 1.33; 95% CI, 1.09-1.63), In-total homocysteine (HR = 1.32; 95% CI, 1.11-1.58) and vascular endothelial growth factor (VEGF; HR = 1.25; 95% CI, 1.07-1.46) were associated with incident ischemic stroke. In the second model, also adjusted for systolic BP, treatment for hypertension, current smoking, diabetes, CVD and atrial fibrillation, only the association with In-CRP (HR = 1.13; 95% CI, 0.92-1.4) did not remain significant.
Of the four biomarkers, adding VEGF to the clinical Framingham stroke risk profile had the greatest effect on the score’s predictability (net reclassification improvement, 0.27; 95% CI, 0.03-0.5), but the strongest improvement in ischemic stroke prediction was observed when all four biomarkers were included (net reclassification improvement, 0.34; 95% CI, 0.12-0.57), according to the researchers.
According to Shoamanesh, the study was observational and, therefore, could not establish a causal relationship between the high levels of the four biomarkers with stroke. “Our study does not provide evidence that these markers are validated well enough to be implemented in clinical practice,” he said.
Other limitations included that infections and other conditions were not accounted for and study participants were mainly of European ancestry, the researchers wrote. – by Tracey Romero
Disclosure: DiaDexus and GlaxoSmithKline provided certain measurements to the researchers at no cost. The researchers report no relevant financial disclosures.