Prevent stroke?

Stroke, commonly referred to as "stroke", is the second leading cause of death in the world, after cardiovascular disease (CVD).

Stroke is caused by the sudden rupture of blood vessels in the brain, or cerebral ischemia and hypoxia due to blockage of blood vessels.

Clinically, it is divided into two categories: hemorrhagic and ischemic.

Among them, acute ischemic stroke (AIS) accounts for about 87% of all strokes.

China is the country with the highest burden of stroke in the world, with a lifetime risk as high as 39.
3%.

Stroke has the characteristics of high morbidity, high mortality, high disability rate, and high recurrence rate.

At present, there are as many as 13 million survivors in my country.

According to the latest "China Stroke Report 2019" issued by the Chinese Stroke Society and the Chinese Center for Disease Control and Prevention, in 2018 alone, the number of deaths due to stroke in my country was 1.
57 million, accounting for about one-third of the global deaths from stroke and the total deaths of residents.
The rate is 22.
3%, which means that one out of every five deaths in our country will die of a stroke.

Therefore, stroke has become the main cause of death and disability among adults in our country, as well as the first cause of premature death and disease burden.

In the past few decades, with the continuous acceleration of social aging and urbanization, the prevalence of residents' unhealthy life>
The incidence of stroke in my country continues to increase, and the burden of disease is showing an "explosive increase" trend.

It is speculated that the incidence of stroke in my country in 2030 will be about 50% higher than in 2010.

The burden of stroke disease in different countries/regions around the world.

Lancet Neurol 2019; 18: 439-58.
So, are there blood biomarkers that can predict stroke in advance and provide the possibility for preventive measures in advance? To this end, neurology experts from the University of Barcelona in Spain have carried out relevant research, and the results have been published in the journal Neurology.

The study included patients with suspected stroke admitted within 4.
5 hours of onset (a total of 189 patients, including 154 AIS and 35 ICH).

Blood samples were collected on admission, and immunoassay was used to determine the levels of glial fibrillary acid protein (GFAP), retinol binding protein 4 (RBP-4), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and endostatin.

Endostatin is the tumor angiogenesis inhibitor with the strongest effect and the best experimental effect.
It has attracted much attention in recent years.
It has undergone phase I and phase II clinical trials in the United States, and may become a new generation of anti-tumor drugs.

The results showed that compared with ICH patients, AIS patients had higher levels of RBP-4, NT-proBNP and endostatin, and lower levels of GFAP.

Among them, the best biomarker combination for identifying AIS is RBP-4+NT-proBNP, which can identify 29.
7% of AIS patients with a specificity of 100%.

Furthermore, in the subgroup of patients whose GFAP was measured by a highly sensitive detection method, RBP-4, NT-proBNP and GFAP can identify 51.
5% of AIS patients with 100% specificity.

In summary, biomarkers including RBP-4, NT-proBNP, and GFAP have a specificity of 100% for the diagnosis of ischemic stroke and a certain sensitivity.

If confirmed in future studies, this group of serum markers may allow patients to receive pre-hospital treatment in advance.

Original source: Blood Biomarkers to Differentiate Ischemic and Hemorrhagic Strokes.
https://doi.
org/10.
1212/WNL.
0000000000011742