대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제54권4호
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  • Pages.256-264
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  • 2022
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  • 1738-3544(pISSN)
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  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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허혈성 뇌졸중에서 심혈관 질환과 심방세동을 위한 혈청 바이오마커: 체계적 문헌 고찰과 메타분석

Serum Biomarkers for Cardiovascular Disease and Atrial Fibrillation in Ischemic Stroke: A Systematic Review and Meta-Analysis

  • 우명수 (전주기전대 임상병리과) ;
  • 문소라 (을지대학교 임상병리학과(성남)) ;
  • 이지영 (을지대학교 임상병리학과(의정부))
  • Myoung Soo, Woo (Department of Biomedical Laboratory Science, Jeonju Kijeon College) ;
  • Sora, Mun (Department of Biomedical Laboratory Science, College of Health Science, Eulji University) ;
  • Jiyeong, Lee (Department of Biomedical Laboratory Science, College of Health Science, Eulji University)
  • 투고 : 2022.07.20
  • 심사 : 2022.11.29
  • 발행 : 2022.12.31
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⟨ 이전 논문 다음 논문 ⟩

초록

허혈성 뇌졸중은 뇌동맥의 혈전이나 색전에 의해 폐색되어 산소가 포함된 혈액이 뇌에 도달하는 것을 방지하고, 신경 세포의 괴사를 유발하는 것이다. 본 연구의 목적은 지금까지 연구된 허혈성 뇌졸중의 조기 진단을 가능하게 하는 심혈관 질환 및 심방세동 질환과 관련된 혈청 후보 마커를 정리하고, 각 마커의 OR을 비교 분석하는 것이다. 본 연구에서는 메타분석 기법을 이용하여 혈청 후보 마커의 효과 크기를 분석하고자 하였다. '심혈관질환', '심방세동', '허혈성 뇌졸중', '혈청 표지자'를 키워드로 포함하는 논문에 대한 학술 Database 검색에서 추출된 데이터는 모두 허혈성 뇌졸중 환자에 대한 결과로 제한하였다. 이 연구에서 가장 많이 검색된 마커는 NT-proBNP, D-dimer, CRP 및 GFAP 등으로 나타났다. 결론적으로, NT-proBNP는 허혈성 뇌졸중의 조기 진단에 매우 유용한 것으로 보이며, 특히 심방세동(AF)의 표지자로 알려져 있으며, 앞으로 더 많은 심방세동 표지자가 발굴되어 연구되어야 할 것이다.

Ischemic stroke is caused by an occlusion by a thrombus or embolus in a cerebral artery, preventing oxygenated blood from reaching the brain and causing the necrosis of nerve cells. This paper summarizes the serum candidate markers associated with cardiovascular disease and atrial fibrillation (AF) disease that enable an early diagnosis of ischemic stroke studied thus far and compares the odds ratio (OR) of each marker. This study examined the effect size of these serum candidate markers using meta-analysis techniques. The academic database search screening for articles containing the keywords "cardiovascular disease," "atrial fibrillation," "ischemic stroke," and "serum marker" was limited to results for patients with ischemic stroke. The most derived markers in this study were N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), D-dimer, C-reactive protein (CRP), and glial fibrillary acidic protein (GFAP), the rest being investigated individually. In conclusion, NT-pro-BNP appears to be very useful for the early diagnosis of ischemic stroke. Primarily, it is a marker of AF, and more AF markers will be uncovered and studied in the future.

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참고문헌

  1. Kuriakose D, Xiao Z. Pathophysiology and treatment of stroke: present status and future perspectives. Int J Mol Sci. 2020;21:7609. https://doi.org/10.3390/ijms21207609
  2. Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, et al. Heart disease and stroke statistics-2022 update: a report from the american heart association. Circulation. 2022;145:e153-e639. https://doi.org/10.1161/CIR.0000000000001052
  3. Whiteley W, Chong WL, Sengupta A, Sandercock P. Blood markers for the prognosis of ischemic stroke: a systematic review. Stroke. 2009;40: e380-e389. https://doi.org/10.1161/STROKEAHA.108.528752
  4. Tarride J-E, Lim M, DesMeules M, Luo W, Burke N, O'Reilly D, et al. A review of the cost of cardiovascular disease. Can J Cardiol. 2009;25:e195-e202. https://doi.org/10.1016/S0828-282X(09)70098-4
  5. Hijazi Z, Wallentin L, Lindback J, Alexander JH, Connolly SJ, Eikelboom JW, et al. Screening of multiple biomarkers associated with ischemic stroke in atrial fibrillation. J Am Heart Assoc. 2020;9:e018984. https://doi.org/10.1161/JAHA.120.018984
  6. Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB, Davis EM, et al. Screening for atrial fibrillation: US preventive services task force recommendation statement. JAMA. 2022;327:360-367. https://doi.org/10.1001/jama.2021.23732
  7. Singleton MJ, Yuan Y, Dawood FZ, Howard G, Judd SE, Zakai NA, et al. Multiple blood biomarkers and stroke risk in atrial fibrillation: the regards study. J Am Heart Assoc. 2021;10:e020157. https://doi.org/10.1161/JAHA.120.020157
  8. Kang H. Statistical considerations in meta-analysis. Hanyang Med Rev. 2015;35:23-32. https://doi.org/10.7599/hmr.2015.35.1.23
  9. Nahm FS. Understanding effect sizes. Hanyang Med Rev. 2015;35:40-43. https://doi.org/10.7599/hmr.2015.35.1.40
  10. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10:89. https://doi.org/10.1186/s13643-021-01626-4
  11. Ottawa Hospital Research Institute. 2021. [Internet]. Ottawa: Canada; 2021 [cited 2022 December 16]. Available from: https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
  12. Harpaz D, Bajpai R, Ng GJL, Soljak M, Marks RS, Cheung C, et al. Blood biomarkers to detect new-onset atrial fibrillation and cardioembolism in ischemic stroke patients. Heart Rhythm. 2021;18:855-861. https://doi.org/10.1016/j.hrthm.2021.01.032
  13. Ramos-Pachon A, Lopez-Cancio E, Bustamante A, Perez de la Ossa N, Millan M, Hernandez-Perez M, et al. D-dimer as predictor of large vessel occlusion in acute ischemic stroke. Stroke. 2021;52:852-858. https://doi.org/10.1161/strokeaha.120.031657
  14. Zhao J, Zhang Y, Yuan F, Song C, Jiang Y, Gao Q, et al. Diagnostic value of N-terminal pro B-type natriuretic peptide for nonvalvular atrial fibrillation in acute ischemic stroke patients: a retrospective multicenter case-control study. J Neurol Sci. 2020;414:116822. https://doi.org/10.1016/j.jns.2020.116822
  15. Garcia-Carmona JA, Conesa-Garcia E, Vidal-Mena D, GonzalezMorales M, Ramos-Arenas V, Sanchez-Vizcaino-Buendia C, et al. Increased plasma levels of N-terminal pro-B-type natriuretic peptide as biomarker for the diagnosis of cardioembolic ischaemic stroke. Neurologia. 2022. In Press. https://doi.org/10.1016/j.nrl.2021.09.014
  16. Zhang M, Wang Y, Wang J, Li X, Ma A, Pan X. Serum LRG1 as a novel biomarker for cardioembolic stroke. Clinica Chimica Acta. 2021;519:83-91. https://doi.org/10.1016/j.cca.2021.04.002
  17. Yang X, Lu T, Qu Z, Zhang Y, Liu P, Ma Y. Plasma D-dimer level is associated with clinical outcomes in patients with atrial fibrillation related acute ischemic stroke after pneumonia. BMC Neurol. 2021;21:137. https://doi.org/10.1186/s12883-021-02168-x
  18. Marta-Enguita J, Navarro-Oviedo M, Rubio-Baines I, Aymerich N, Herrera M, Zandio B, et al. Association of calprotectin with other inflammatory parameters in the prediction of mortality for ischemic stroke. J Neuroinflammation. 2021;18:3. https://doi.org/10.1186/s12974-020-02047-1
  19. Da Silva-Candal A, Dopico-Lopez A, Perez-Mato M, RodriguezYanez M, Pumar JM, avila-Gomez P, et al. Characterization of a temporal profile of biomarkers as an index for ischemic stroke onset definition. J Clin Med. 2021;10:3136. https://doi.org/10.3390/jcm10143136
  20. Mengozzi M, Kirkham FA, Girdwood EER, Bunting E, Drazich E, Timeyin J, et al. C-reactive protein predicts further ischemic events in patients with transient ischemic attack or lacunar stroke. Front Immunol. 2020;11:1403. https://doi.org/10.3389/fimmu.2020.01403
  21. Chen CH, Chu HJ, Hwang YT, Lin YH, Lee CW, Tang SC, et al. Plasma neurofilament light chain level predicts outcomes in stroke patients receiving endovascular thrombectomy. J Neuroinflammation. 2021;18:195. https://doi.org/10.1186/s12974-021-02254-4
  22. Ma J, Shen L, Bao L, Yuan H, Wang Y, Liu H, et al. A novel prognosis prediction model, includin cytotoxic T lymphocyte-associated antigen-4, ischemia-modified albumin, lipoprotein-associated phospholipase A2, glial fibrillary acidic protein, and homocysteine, for ischemic stroke in the Chinese hypertensive population. J Clin Lab Anal. 2021;35:e23756. https://doi.org/10.1002/jcla.23756
  23. Dong S, Pei B, Xie W, Wang J, Zeng Q. Anticardiolipin antibody and anti-β2 glycoprotein I antibody are potential risk markers of ischaemic stroke in Chinese adults. Rheumatology (Oxford). 2020;59:1834-1841. https://doi.org/10.1093/rheumatology/kez551
  24. Chen Z, Hu Q, Huo Y, Zhang R, Fu Q, Qin X. Serum interleukin-33 is a novel predictive biomarker of hemorrhage transformation and outcome in acute ischemic stroke. J Stroke Cerebrovasc Dis. 2021;30:105506. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105506
  25. Schwedhelm E, von Lucadou M, Peine S, Lezius S, Thomalla G, Boger R, et al. Trimethyllysine, vascular risk factors and outcome in acute ischemic stroke (MARK-STROKE). Amino Acids. 2021;53:555-561. https://doi.org/10.1007/s00726-021-02969-x