Table 1.
Summary of the 12 articles included in the systematic review.
| Biomarker panel | Sample size (n)/groups | Time | Essays | Cut off | Specificity | Sensitivity | Area under the curve | References |
|---|---|---|---|---|---|---|---|---|
| BNP, D-dimer, MMP-9, and S100β ICH vs. mimics |
n = 946 subjects 293 (IS), 95 (ICH), 197 (TIA), and 361 (mimics) 343 subjects for the validation cohort: 87 (IS), 64 (ICH), 40 (TIA), and 152 (mimics) ICH vs. mimics |
0–3 h 3–6 h |
Triage Stroke Panel (fluorescence immunoassay) | MMP-9: 25–1,300 ng/mL D-dimer: 150–5,000 ng/mL S100β: 100–8,000 pg/mL BNP: 10–5,000 pg/mL |
Stroke vs. mimics: 45% ICH vs. mimics: 38% |
Stroke vs. mimics: 90% ICH vs. mimics: 88% |
Stroke vs. mimics: 0.75 ICH vs. mimics: 0.81 |
(23) |
| BNP, D-dimer, MMP-9, S100β, and multimarker index (MMX) |
n = 139 subjects 89 (AIS), 11 (ICH), and 39 (brain disorders) AIS vs. others (control, brain diseases) |
<6 h | Triage® Meter (Biosite Inc.) fluorescence immunoassay | MMP-9: 25–1,300 ng/mL D-dimer: 150–5,000 ng/mL S100β: 100–8,000 pg/mL BNP: 10–5,000 pg/mL |
21.5% | 91.0% | 0.714 | (24) |
| BNP, D-dimer, MMP-9, S100β, and multimarker index (MMX) |
n = 174 subjects 100 (IS), 49 (mimics), and 25 (TIA) IS vs. mimics |
<6 h | Triage® Stroke Panel | — | 33% | 86% | 0.59 | (25) |
| Eotaxin, EGFR, S100A12, TIMP-4, and prolactin |
n = 167 subjects 57 (IS), 32 (ICH), 41 (TIA), and 37 (mimics) IS + ICH vs. mimics |
<24 h | — | — | 84% IS vs. mimics (c = 0.92) |
90% | 0.97 | (26) |
| D-dimer, caspase-3, sRAGE, MMP-9 chimerin, and secretagogin |
n = 1,005 subjects 776 (IS), 139 (ICH), and 90 (mimics) IS vs. mimics |
<6 h | ELISA immunoassays | Caspase-3: 1.962 ng/mL D-dimer: 0.275 μg/mL sRAGE: 0.91 ng/mL chimerin: 1.11 ng/mL secretagogin: 0.24 ng/mL MMP-9: 199 ng/mL |
63% | 84% | 0.810 (0.757–0.863) | (27) |
| S100β, MMP-9, VCAM, and vWF |
n = 80 subjects 44 (IS), 21 (controls), 13 (TIA), 1 (syncope), 1 other conditions Stroke vs. controls |
<6 h 6–24 h |
Biosite Inc. | — | 90% | 90% | — | (28) |
| S100β, BNGF, vWF, MMP-9, and MCP-1 |
n = 274 subjects 82 (ISCH), 65 (SAH), 38 (ICH), 38 (closed head injuries, CLH), and 51 (TIA) AIS vs. other groups ICH vs.other groups |
<6 h | ELISA-immunoassays | — | 93% | AIS: 91.7% ICH: 80% |
— | (29) |
| IMA index IMA |
n = 52 subjects 28 (IS) and 24 (No-Stroke) IS vs. no stroke |
<6 h | Albumin–cobalt binding (ACB) test | 91.4 U/mL | 96.4% | 95.8% | 0.990 (0.970–1.000) | (30) |
| AT-III Fibrinogen |
n = 198 subjects 152 (IS) and 46 (mimics) IS vs. no stroke |
4.5 h | AT-III: chromogenic assay Fib: immunoturbidimetry assay |
AT-III: 210% Fib: 4 g/L |
AT-III:93.62% F: 82.61% |
AT-III: 97.37% F: 96.05% |
— | (31) |
| Ab NR2 and GFAP |
n = 124 subjects 49 (IS), 23 (ICH), 52 controls IS vs. ICH |
<12 h | GFAP: ELISA kit AB NR2: Gold Dot NR2 Antibody Assay kit (ELISA) |
— | 91% | 94% | — | (32) |
| GFAP/UCH-L1 GFAP |
n = 184 subjects 45 (ICH), 79 (IS), 5 (SAH), 3 (TIA), and 57 controls IS vs. controls ICH vs. controls IS vs. ICH |
<4.5 h | ELISA immunoassays | GFAP: 0.34 ng/mL | — — |
— — |
0.875 0.71 (IS vs. C) 0.95 (ICH vs. C) 0.86 (IS vs. ICH) |
(33) |
| ApoC-III, NT-proBNP, and FasL (21 biomarkers) |
n = 1,308 subjects 941 (IS), 193 (mimics) and 174 (hemorrhagic) 767 validation cohort IS vs. mimics IS vs. ICH |
<6 h | ELISA immunoassays | — | — | — |
IS vs. mimics 0.742 (0.686–0.797) IS vs. ICH 0.757 (0.691–0.823) |
(34) |
ROC analysis includes clinical variables selected by the authors. Bold values indicate groups compared in the studies analyzed by Receiver Operating Curve analysis (ROC).