OBJECTIVE: Stroke has become the second most common cause of death. Several biomarkers have been detected in the peripheral blood from stroke patients, but none has found a place in clinical practice. Cell-free DNA (cf-DNA) liberated into the blood soon after the onset of stroke might be useful for assessing disease severity and prognosis. STUDY DESIGN AND METHODS: A total of 54 patients presenting with ischemic stroke were recruited consecutively with the exclusion of patients having trauma, tumor, infections, and organ failure. The cf-DNA was extracted by circulating nucleic acid kit from Qiagen and measured by real-time quantitative polymerase chain reaction assay for β-globin gene. The primary outcome measure was poststroke modified Rankin scale Score at 3 months after the onset of symptoms. RESULTS: Higher cf-DNA levels were associated with severity at the time of admission measured by National Institutes of Health Stroke Scale (P=0.003) and poor outcome as measured by modified Rankin scale 3-month scores (P=0.001). Therapeutic intervention in the form of a mechanical thrombectomy or IV thrombolysis was associated with improved outcome in patients with cf-DNA<10,000 kilogenome-equivalents/L (P≤0.01). CONCLUSIONS: cf-DNA level correlates well with the severity of stroke at admission and long-term prognosis. It can be used as an additional marker to predict the outcome of therapeutic intervention.
OBJECTIVE:Stroke has become the second most common cause of death. Several biomarkers have been detected in the peripheral blood from strokepatients, but none has found a place in clinical practice. Cell-free DNA (cf-DNA) liberated into the blood soon after the onset of stroke might be useful for assessing disease severity and prognosis. STUDY DESIGN AND METHODS: A total of 54 patients presenting with ischemic stroke were recruited consecutively with the exclusion of patients having trauma, tumor, infections, and organ failure. The cf-DNA was extracted by circulating nucleic acid kit from Qiagen and measured by real-time quantitative polymerase chain reaction assay for β-globin gene. The primary outcome measure was poststroke modified Rankin scale Score at 3 months after the onset of symptoms. RESULTS: Higher cf-DNA levels were associated with severity at the time of admission measured by National Institutes of Health Stroke Scale (P=0.003) and poor outcome as measured by modified Rankin scale 3-month scores (P=0.001). Therapeutic intervention in the form of a mechanical thrombectomy or IV thrombolysis was associated with improved outcome in patients with cf-DNA<10,000 kilogenome-equivalents/L (P≤0.01). CONCLUSIONS: cf-DNA level correlates well with the severity of stroke at admission and long-term prognosis. It can be used as an additional marker to predict the outcome of therapeutic intervention.
Authors: Suphamai Bunnapradist; Nakul Datta; Joanna Schaenman; Nick Ioannou; Michelle S Bloom; Meenakshi Malhotra; Hossein Tabriziani; Philippe Gauthier; Ebad Ahmed; Paul R Billings; Erik L Lum Journal: Transplant Direct Date: 2021-04-23