NeuroMolecular Medicine

, Volume 21, Issue 4, pp 344–368 | Cite as

Blood Biomarkers for Stroke Diagnosis and Management

  • Joseph Kamtchum-TatueneEmail author
  • Glen C. Jickling
Review Paper


Biomarkers are objective indicators used to assess normal or pathological processes, evaluate responses to treatment and predict outcomes. Many blood biomarkers already guide decision-making in clinical practice. In stroke, the number of candidate biomarkers is constantly increasing. These biomarkers include proteins, ribonucleic acids, lipids or metabolites. Although biomarkers have the potential to improve the diagnosis and the management of patients with stroke, there is currently no marker that has demonstrated sufficient sensitivity, specificity, rapidity, precision, and cost-effectiveness to be used in the routine management of stroke, thus highlighting the need for additional work. A better standardization of clinical, laboratory and statistical procedures between centers is indispensable to optimize biomarker performance. This review focuses on blood biomarkers that have shown promise for translation into clinical practice and describes some newly reported markers that could add to routine stroke care. Avenues for the discovery of new stroke biomarkers and future research are discussed. The description of the biomarkers is organized according to their expected application in clinical practice: diagnosis, treatment decision, and outcome prediction.


Stroke Biomarker Genomics Proteomics Diagnosis Management 



Adjusted hazard ratio


Adjusted odds ratio


A disintegrin and metalloproteinase with thrombospondin type-1 motif, member 13


Atrial natriuretic peptide


Apolipoprotein A1 unique peptide


B-type natriuretic peptide


Clinical diffusion mismatch


Cellular fibronectin


C-reactive protein


Computerized tomography


Decompressive hemicraniectomy


Early neurological deterioration


Endovascular thrombectomy


Fold change


Glial fibrillary acid protein


Glycated hemoglobin


Heart-type fatty acid-binding protein


Hazard ratio


Hemorrhagic transformation


Intercellular adhesion molecule


Intracerebral hemorrhage


Interleukin 10




Ischemic stroke


Large artery atherosclerosis


Long non-coding RNA


Lipoprotein-associated phospholipase A2


Middle cerebral artery


Mannose-binding lectin


Matrix metalloproteinase 9




Mid-regional pro-atrial natriuretic peptide


Magnetic resonance imaging


Modified Rankin Scale


Mass spectrometry


Not applicable or not available


Nucleoside diphosphate kinase A


Neurofilament light




National Institutes of Health Stroke Scale


Neuron-specific enolase


N-terminal pro-B-type natriuretic peptide


Odds ratio


Plasminogen activator inhibitor 1


Parkinson disease protein 7


Platelet basic protein


Retinol-binding protein 4


Ribonucleic acid


Serum calcium-binding protein






Thrombin-activatable fibrinolysis inhibitor


Transient ischemic attack


Tumor necrosis factor α


Tissue plasminogen activator


Vascular cell adhesion molecule


Vascular endothelial growth factor


von Willebrand factor


Zinc finger antisense 1


Author Contributions

JK-T did the literature search and drafted the manuscript. GCJ critically revised the initial draft and all the subsequent versions. All authors have approved the final version of the manuscript.


GCJ receives research support from the Canadian Institutes of Health Research (CIHR), the Heart and Stroke Foundation, the University Hospital Foundation, and the National Institutes of Health (NIH).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This review is based solely on previously published articles from ethically approved studies. The work did not involve human or animal experiments and did not require the collection of new data. Therefore, no ethical approval or consent was required.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Neuroscience and Mental Health Institute, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
  2. 2.Division of Neurology, Department of MedicineUniversity of AlbertaEdmontonCanada

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