Troponin and bnp based diagnosis of risk patients and cause of stroke

Abstract

Method for early differentiation of whether a subject suffers from cardioembolic stroke or from non-cardioembolic ischemic stroke based on the determination of the amount of a cardiac Troponin in a sample from a subject who is suffering from ischemic stroke, the sample obtained not more than 24 hours after the onset of symptoms of ischemic stroke. Kits and devices adapted to carry out the methods are also provided.

1 . (canceled) 
     
     
         2 . A method of diagnosing intermittent atrial fibrillation in a patient suffering from atrial fibrillation, the method comprising the steps of:
 contacting, in vitro, a portion of a sample obtained from the patient with a binding agent that specifically binds a cardiac Troponin, whereby a complex of the binding agent and the cardiac Troponin is formed;   separating the complex from binding agent and sample not comprising the complex;   measuring the amount of complex separated in said step of separating, whereby a concentration of the cardiac Troponin in the sample is calculated;   comparing the concentration of the cardiac Troponin in the sample to a first cardiac Troponin reference concentration and a second cardiac Troponin reference concentration, the second cardiac Troponin reference concentration being greater than the first cardiac Troponin reference concentration; and   providing a diagnosis of intermittent atrial fibrillation in the patient if the concentration of the cardiac Troponin is greater than the first cardiac Troponin reference concentration and less than the second cardiac Troponin reference concentration.   
     
     
         3 . The method of  claim 2 , wherein the sample is one of whole blood, serum or plasma. 
     
     
         4 . The method of  claim 2 , wherein the binding agent is an antibody. 
     
     
         5 . The method of  claim 2 , wherein the binding agent comprises a detectable marker. 
     
     
         6 . The method of  claim 5 , wherein said step of measuring comprises quantifying a signal from the detectable label of binding agent comprising the complex. 
     
     
         7 . The method of  claim 2 , wherein the sample is obtained from the patient within 6 hours of onset of symptoms of atrial fibrillation. 
     
     
         8 . The method of  claim 2 , wherein the cardiac Troponin is Troponin T. 
     
     
         9 . The method of  claim 2 , wherein the second cardiac Troponin reference concentration is determined from a cardiac Troponin reference concentration of a sample obtained from at least one individual previously identified as suffering from atrial fibrillation. 
     
     
         10 . The method of  claim 9 , wherein the first cardiac Troponin reference concentration is determined from a cardiac Troponin reference concentration of a sample obtained from at least one individual previously identified as not suffering from atrial fibrillation and not suffering from intermittent atrial fibrillation. 
     
     
         11 . A method of diagnosing intermittent atrial fibrillation in a patient suffering from atrial fibrillation, the method comprising the steps of:
 contacting a portion of a sample obtained from the patient with a capture antibody having specific binding affinity for a first epitope of a cardiac Troponin and with a detection antibody having specific binding affinity for a second epitope of the cardiac Troponin, thereby forming a complex of the capture antibody, cardiac Troponin and the detection antibody, the first epitope being different than the second epitope, the detection antibody having a detectable label;   binding the complex of the capture antibody, cardiac Troponin and detection antibody with a solid support;   separating the complex of the capture antibody, cardiac Troponin and detection antibody bound to the solid support from capture antibody, detection antibody and cardiac Troponin not bound to the solid support;   detecting a signal from the detectable label of the detection antibody comprising the complex separated from capture antibody, detection antibody and cardiac Troponin not bound to the solid support;   quantifying the signal detected in said step of detecting, the signal being proportional to an amount of the cardiac Troponin in the sample from the patient, whereby a concentration of the cardiac Troponin in the sample is calculated;   comparing the concentration of the cardiac Troponin calculated in said step of quantifying to a first cardiac Troponin reference concentration and a second cardiac Troponin reference concentration, the second cardiac Troponin reference concentration being greater than the first cardiac Troponin reference concentration; and   providing a diagnosis of intermittent atrial fibrillation in the patient if the concentration of the cardiac Troponin in the sample calculated in said step of quantifying is greater than the first cardiac Troponin reference concentration and less than the second cardiac Troponin reference concentration.   
     
     
         12 . The method of  claim 11 , wherein the sample is one of whole blood, serum or plasma. 
     
     
         13 . The method of  claim 11 , wherein the sample is obtained from the patient within 6 hours of onset of symptoms of atrial fibrillation. 
     
     
         14 . The method of  claim 11 , wherein the cardiac Troponin is Troponin T. 
     
     
         15 . The method of  claim 11 , wherein the second cardiac Troponin reference concentration is determined from a cardiac Troponin reference concentration of a sample obtained from at least one individual previously identified as suffering from atrial fibrillation. 
     
     
         16 . The method of  claim 11 , wherein the first cardiac Troponin reference concentration is determined from a cardiac Troponin reference concentration of a sample obtained from at least one individual previously identified as not suffering from atrial fibrillation and not suffering from intermittent atrial fibrillation.