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      Blood Biomarkers in Cardioembolic Stroke

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          Abstract

          One promising field in neurovascular diseases investigation is the use of biomarkers to guide stroke etiology diagnosis and classification. Since treatment differs among etiologic subtypes and nowadays many patients receive a diagnosis of undetermined stroke, biomarkers might become an important additional diagnostic tool. In this review we update current knowledge about biomarkers related with cardioembolic stroke etiology (such as BNP and D-dimer proteins, or PITX2 and ZFHX3 genes), that in the future, might allow rapidly guiding other diagnostic tests and accelerating the onset of an optimal secondary prevention.

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          Variants conferring risk of atrial fibrillation on chromosome 4q25.

          Daniel Fannar Gudbjartsson, David O Arnar, Anna Helgadottir … (2007)
          Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in humans and is characterized by chaotic electrical activity of the atria. It affects one in ten individuals over the age of 80 years, causes significant morbidity and is an independent predictor of mortality. Recent studies have provided evidence of a genetic contribution to AF. Mutations in potassium-channel genes have been associated with familial AF but account for only a small fraction of all cases of AF. We have performed a genome-wide association scan, followed by replication studies in three populations of European descent and a Chinese population from Hong Kong and find a strong association between two sequence variants on chromosome 4q25 and AF. Here we show that about 35% of individuals of European descent have at least one of the variants and that the risk of AF increases by 1.72 and 1.39 per copy. The association with the stronger variant is replicated in the Chinese population, where it is carried by 75% of individuals and the risk of AF is increased by 1.42 per copy. A stronger association was observed in individuals with typical atrial flutter. Both variants are adjacent to PITX2, which is known to have a critical function in left-right asymmetry of the heart.
          Article 0 comments Cited 217 times – based on 0 reviews     Review now
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            Classification of Stroke Subtypes

            P Amarenco, J Bogousslavsky, L.R. Caplan … (2009)
            This article reviews published stroke subtype classification systems and offers rules and a basis for a new way to subtype stroke patients. Stroke subtyping can have different purposes, e.g. describing patients’ characteristics in a clinical trial, grouping patients in an epidemiological study, careful phenotyping of patients in a genetic study, and classifying patients for therapeutic decision-making in daily practice. The classification should distinguish between ischemic and hemorrhagic stroke, subarachnoid hemorrhage, cerebral venous thrombosis, and spinal cord stroke. Regarding the 4 main categories of etiologies of ischemic stroke (i.e. atherothrombotic, small vessel disease, cardioembolic, and other causes), the classification should reflect the most likely etiology without neglecting the vascular conditions that are also found (e.g. evidence of small vessel disease in the presence of severe large vessel obstructions). Phenotypes of large cohorts can also be characterized by surrogate markers or intermediate phenotypes (e.g. presence of internal carotid artery plaque, intima-media thickness of the common carotid artery, leukoaraiosis, microbleeds, or multiple lacunae). Parallel classifications (i.e. surrogate markers) may serve as within-study abnormalities to support research findings.
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              Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data.

              Tim Issac, N Lakkis, Hisham Dokainish (2007)
              Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Recent studies have indicated that inflammation might play a significant role in the initiation, maintenance, and perpetuation of AF. Inflammatory markers such as interleukin-6 and C-reactive protein are elevated in AF and correlate to longer duration of AF, success of cardioversion, and thrombogenesis. Furthermore, the inflammatory process might be modulated by the use of statins, angiotensin-converting enzyme inhibitors, or glucocorticoids. The purpose of this study is to analyze the current published reports on the relationship between inflammation and AF and the potential therapeutic options available to modulate the inflammatory milieu in AF.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Curr Cardiol Rev
                Journal ID (publisher-id): CCR
                Title: Current Cardiology Reviews
                Publisher: Bentham Science Publishers Ltd.
                ISSN (Print): 1573-403X
                ISSN (Electronic): 1875-6557
                Publication date (Print): August 2010
                Volume: 6
                Issue: 3
                Pages: 194-201
                Affiliations
                []Neurovascular Research Laboratory, Institut de Recerca Vall d’Hebron and Neurovascular Unit Neurology Department. Universitat Autònoma de Barcelona. Medicine Department. Hospital Vall d’Hebron. Barcelona, Spain
                Author notes
                [* ]Address correspondence to this author at the Neurovascular Research Laboratory, Neurovascular Unit, Institut de Recerca, Hospital Vall d’Hebron, Pg Vall d’Hebron 119-129, 08035 Barcelona, Spain; Tel: +34934894073; Fax: +34934894015; E-mail: 31862jmv@ 123456comb.cat
                Article
                Publisher ID: CCR-6-194
                DOI: 10.2174/157340310791658767
                PMC ID: 2994111
                PubMed ID: 21804778
                SO-VID: 50d91786-b300-425b-a92a-7f04a05752d9
                Copyright © © 2010 Bentham Science Publishers Ltd.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 10 April 2010
                Date revision received : 10 April 2010
                Date accepted : 25 May 2010
                Categories
                Subject: Article

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: classification,etiology,cardioembolic,biomarker,natriuretic peptides,stroke.
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: classification, etiology, cardioembolic, biomarker, natriuretic peptides, stroke.

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