MedWire News: US research indicates that testing for two inflammatory biomarkers may improve risk assessment for ischemic stroke in middle-aged adults.
The findings, reported in the journal Stroke, showed that testing for high-sensitivity C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) was particularly informative among those already classified as at intermediate risk for ischemic stroke due to traditional risk factors.
Vijay Nambi (Baylor College of Medicine, Houston, Texas) assessed 949 participants of the Atherosclerosis Risk in Communities (ARIC) study, who provided blood samples that were tested for hs-CRP and Lp-PLA2. Traditional risk factors including smoking, blood pressure, cholesterol levels, and diabetes were also assessed at baseline.
After 5 years follow-up, 183 (19%) of the participants had suffered an ischemic stroke.
Nambi et al report that using traditional risk factors alone to evaluate 5-year stroke risk, 86% of participants were classified as low risk, 11% as intermediate risk, and 3% as high risk.
Adding information about the two inflammatory markers changed this classification in around 14% of the participants, primarily due to reclassification from the intermediate to high risk category, and vice versa, or from the intermediate to low-risk category.
Furthermore, addition of information about hs-CRP and Lp-PLA2 significantly improved the prediction of 5-year ischemic stroke compared with traditional risk factors alone. This improvement was even greater when the interaction between hs-CRP and Lp-PLA2 was taken into account.
“While more studies must be done to determine if these categories can be used as a standard, these results show us one strategy to classify an individual's stroke risk and how this can be altered by the addition of novel blood tests,” Nambi said.
“Future studies should determine if changing treatment options based on risk could improve the prevention of ischemic stroke,” he recommended.
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