Prognosis and risk assessment in stroke patients by determining the level of marker peptides

Abstract

The present invention relates to a method for prognosis of an outcome or assessing the risk of a patient having suffered a stroke or a transient ischemic attack, comprising the determination of the level of at least one marker peptide in said sample said marker peptide selected from the group comprising ANP, AVP, ADM, ET-1, troponin, CRP, calcitonin and hGH or fragments thereof or its precursor or fragments thereof and attributing the level of said at least one marker peptides its precursor or fragments thereof with the prognosis of an outcome or assessing the risk for said patient.

1 . A method for prognosis of an outcome or assessing the risk of a patient having suffered a stroke or a transient ischemic attack, comprising the following steps:
 a. providing a sample from said patient,   b. determining the level of at least one cardiovascular peptide in said sample said cardiovascular peptide selected from the group comprising ANP, AVP, ADM, ET-1, calcitonin, troponin, CRP and hGH or fragments thereof or its precursor or fragments thereof,   c. correlating the level of said at least one marker peptide, or fragments thereof or its precursor or fragments thereof with the prognosis of an outcome or assessing the risk for said patient.   
     
     
         2 . A method according to  claim 1 , wherein said sample is taken pre-interventionally. 
     
     
         3 . A method according to  claim 1 , wherein said outcome or said risk regards survival and/or a functional outcome and/or a re-stroke or a re-transient ischemic attack. 
     
     
         4 . A method for the stratification of a patient into risk groups said patient having suffered a stroke or a transient ischemic attack and said method comprising the steps according to  claim 1  or  2 . 
     
     
         5 . A method for diagnosing a patient according to  claim 4 , wherein the level of said at least one cardiovascular peptide is attributed to either ischemic stroke or hemorrhagic stroke or a transient ischemic attack. 
     
     
         6 . A method according to  claims 1  to  5 , wherein the level of at least two marker peptides is determined. 
     
     
         7 . A method according to  claim 6 , wherein the level of a set of at least two marker peptides is determined and the set of the at least two marker peptides is selected from the group comprising the following combinations of cardiovascular peptides: ANP and AVP, ANP and ADM, ANP and ET-1, ANP and calcitonin, ANP and hGH, ADM and ET-1, ADM and calcitonin, ADM and hGH, ET-1 and calcitonin, ET-1 and hGH, and calcitonin and hGH. 
     
     
         8 . A method according to  claim 6 , wherein each cardiovascular peptide is selected from a different subset of marker peptides selected from the group comprising cardiovascular peptides, endothelial peptides, pituary peptides and inflammatory peptides, wherein the cardiac peptides are selected from the group comprising ANP, BNP and troponin (cT), the endothelial peptides are selected from the group comprising ET-1 and ADM, the pituary peptides are selected from the group comprising AVP and hGH and the inflammatory peptides are selected from the group comprising calcitonin and CRP. 
     
     
         9 . A method according to any of the preceding claims, wherein the level of BNP or fragments thereof or precursors or fragments thereof is additionally determined. 
     
     
         10 . A method according to  claims 1  to  9 , wherein the determination is performed using a multivariate analysis considering in addition covariates selected from a group comprising NIHSS, the Barthel Index and the modified Ranking Scale. 
     
     
         11 . Kit for prognosis of an outcome or assessing the risk of a patient having suffered a stroke or a transient ischemic attack comprising one or more capture probes directed against marker peptides or fragments thereof or precursors or fragments thereof selected from the group comprising ANP, AVP, ADM, ET-1, calcitonin, troponin, CRP and hGH. 
     
     
         12 . Use of the method according to any one of the  claims 1  to  10  or the kit according to  claim 11  for prognosis of an outcome or assessing the risk of a patient having suffered a stroke or a transient ischemic attack. 
     
     
         13 . Use of the method according to any one of the  claims 1  to  10  or the kit according to  claim 11  for monitoring of the therapy in a patient having suffered a stroke or a transient ischemic attack. 
     
     
         14 . Use of the method according to any one of the  claims 1  to  10  or the kit according to  claim 11  for differentiating ischemic stroke from hemorrhagic stroke or for differentiating ischemic and/or hemorrhagic stroke from transient ischemic attack. 
     
     
         15 . Use of the method according to any one of the  claims 1  to  10  or the kit according to  claim 11  for determining whether said patient is suffering from stroke or a transient ischemic attack based on the level of said at least one cardiovascular peptide.