A Systematic Review and Meta-Analysis Assessing the Accuracy of Blood Biomarkers for the Diagnosis of Ischemic Stroke in Adult and Elderly Populations
Issued Date
2024-11-01
Resource Type
eISSN
23732822
Scopus ID
2-s2.0-85209482632
Pubmed ID
39528275
Journal Title
eNeuro
Volume
11
Issue
11
Rights Holder(s)
SCOPUS
Bibliographic Citation
eNeuro Vol.11 No.11 (2024)
Suggested Citation
Ruksakulpiwat S., Zhou W., Phianhasin L., Benjasirisan C., Su T., Aldossary H.M., Kudlowitz A., Challa A.K., Li J., Praditukrit K. A Systematic Review and Meta-Analysis Assessing the Accuracy of Blood Biomarkers for the Diagnosis of Ischemic Stroke in Adult and Elderly Populations. eNeuro Vol.11 No.11 (2024). doi:10.1523/ENEURO.0302-24.2024 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102156
Title
A Systematic Review and Meta-Analysis Assessing the Accuracy of Blood Biomarkers for the Diagnosis of Ischemic Stroke in Adult and Elderly Populations
Author's Affiliation
Rocky Vista University College of Osteopathic Medicine
Prince Sultan Military College of Health Sciences, Dhahran
Second Affiliated Hospital of Harbin Medical University
SUNY Downstate Health Sciences University
Mahidol University
Faculty of Medicine and Health
Peking University Health Science Center
Case Western Reserve University
Prince Sultan Military College of Health Sciences, Dhahran
Second Affiliated Hospital of Harbin Medical University
SUNY Downstate Health Sciences University
Mahidol University
Faculty of Medicine and Health
Peking University Health Science Center
Case Western Reserve University
Corresponding Author(s)
Other Contributor(s)
Abstract
This study aims to elucidate the methodology and compare the accuracy of different blood biomarkers for diagnosing ischemic stroke (IS). We reviewed 29 articles retrieved from PubMed, MEDLINE, Web of Science, and CINAHL Plus with Full Text. Among these, 23 articles involving 3,494 participants were suitable for meta-analysis. The pooled area under the curve (AUC) of all studies for meta-analysis was 0.89. The pooled sensitivity and specificity were 0.76 (0.74-0.78) and 0.84 (0.83-0.86), respectively. Blood biomarkers from noninpatient settings demonstrated better diagnostic performance than those in inpatient settings (AUC 0.91 vs 0.88). Smaller sample sizes (<100) showed better performance than larger ones (≥100; AUC 0.92 vs 0.86). Blood biomarkers from acute IS (AIS) patients showed higher diagnostic values than those from IS and other stroke types (AUC 0.91 vs 0.87). The diagnostic performance of multiple blood biomarkers was superior to that of a single biomarker (AUC 0.91 vs 0.88). The diagnostic value of blood biomarkers from Caucasians was higher than that from Asians and Africans (AUC 0.90 vs 0.89, 0.75). Blood biomarkers from those with comorbidities (AUC 0.92) showed a better diagnostic performance than those not reporting comorbidities (AUC 0.84). All the subgroups analyzed, including setting, sample size, target IS population, blood biomarker profiling, ethnicity, and comorbidities could lead to heterogeneity. Blood biomarkers have demonstrated sufficient diagnostic accuracy for diagnosing IS and hold promise for integration into routine clinical practice. However, further research is recommended to refine the optimal model for utilizing blood biomarkers in IS diagnosis.