• Andrew M Penn, Maximilian B Bibok, Viera K Saly, Shelagh B Coutts, Mary L Lesperance, Robert F Balshaw, Kristine Votova, Nicole S Croteau, Anurag Trivedi, Angela M Jackson, Janka Hegedus, Evgenia Klourfeld... more , Yu Amy Y X AYX http://orcid.org/0000-0002-7276-9551 h Department of Medicine , University of Toronto Sunnybrook Health Sciences Centre , Toronto , ON , Charlotte Zerna, Christoph H Borchers, and SpecTRA study group. less
• a Neurosciences, Stroke Rapid Assessment Clinic , Island Health Authority , Victoria , BC , Canada.
• Biomarkers. 2018 May 1; 23 (4): 392-405.

ObjectiveTo derive a plasma biomarker protein panel from a list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke from non-cerebrovascular (mimic) conditions in emergency department (ED) settings.DesignProspective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 h following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS).ParticipantsTotally 545 participants suspected of TIA enrolled in the EDs of two urban medical centres.Outcomes90-day, neurologist-adjudicated diagnosis of TIA informed by clinical and radiological investigations.ResultsThe final protein panel consists of 16 proteins whose patterns show differential abundance between TIA and mimic patients. Nine of the proteins were significant univariate predictors of TIA [odds ratio (95% confidence interval)]: L-selectin [0.726 (0.596-0.883)]; Insulin-like growth factor-binding protein 3 [0.727 (0.594-0.889)]; Coagulation factor X [0.740 (0.603-0.908)]; Serum paraoxonase/lactonase 3 [0.763 (0.630-0.924)]; Thrombospondin-1 [1.313 (1.081-1.595)]; Hyaluronan-binding protein 2 [0.776 (0.637-0.945)]; Heparin cofactor 2 [0.775 (0.634-0.947)]; Apolipoprotein B-100 [1.249 (1.037-1.503)]; and von Willebrand factor [1.256 (1.034-1.527)]. The scientific plausibility of the panel proteins is discussed.ConclusionsOur panel has the potential to assist ED physicians in distinguishing TIA from mimic patients.

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