Table 1.
Summary of potential cardioembolic stroke biomarkers and levels of evidence.
| Nature | Biomarker | Level of evidence | Possible clinical application |
|---|---|---|---|
| Circulating proteins | Markers of myocardial stress | ||
| NT-proBNP/BNP | Individual patient pooled data and literature-based meta-analysis (30, 31) | Identification of patients that may benefit from anticoagulation in the absence of AF (32); Selection of patients for PCM (33). |
|
| MR-proANP/ANP | Cohort studies (34, 35) | ||
| Cardiac troponin | Cohort studies (36–38) | Selection of patients for further echocardiography evaluation (39, 40) | |
| CK-MB | Cohort studies (41) | ||
| Markers of inflammation | |||
| CRP | Literature-based meta-analysis (42) | ||
| Interleukin-6 | Literature-based meta-analysis (42) | ||
| Interleukin-1β | Cohort studies (43, 44) | ||
| Tumor necrosis factor-α | Cohort studies (43, 44) | ||
| Markers of coagulation | |||
| D-Dimer | Cohort studies (45–50) | Selection of patients to screen for occult cancer (51) | |
| Fibrin monomer complex | Single cohort study (46) | ||
| Soluble fibrin | Single cohort study (46) | ||
| Fibrin degradation products (FDPs) | Single cohort study (46) | ||
| Soluble thrombomodulin | Single cohort study (52) | ||
| Markers of endothelian dysfunction | |||
| sRAGE | Single cohort study (45) | ||
| Genomic markers | RNA panels+ | Single cohort studies (53, 54) | |
| Metabolites | Plasma metabolites* | Single cohort studies (55, 56) | |
| Findings from Echocardiography Examinations | P-wave terminal force in lead V1 (PTFV1) | Indirect evidence (57, 58) | |
| Intra-atrial block (IAB) | Indirect evidence (59) | ||
| Excessive supraventricular ectopic activity (ESVEA) | Indirect evidence (60) | ||
| Findings from electrocardiography examinations | LA- volume index/LA diameter | Cohort studies (61–63) | Identification of patients that may benefit from anticoagulation in the absence of AF (64); Selection of patients for PCM (65) |
| LA strain | Indirect evidence (66) | ||
| Advanced cardiac imaging | Delayed-enhancement cardiac MRI | Indirect evidence (67) |
+
40 gene and 23 gene panel;
*
free fatty acids; tricarboxylic acid metabolites-succinate, α-ketoglutarate, malate.
NT-proBNP, N-terminal pro-B-type natriuretic peptide; BNP, B-type natriuretic peptide; MR-proANP, Midregional pro-atrial natriuretic peptide; CRP, C-reactive protein; LA, left atrium; PCM, prolonged cardiac monitoring; sRAGE, soluble receptor for advanced glycation end products.