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Discrimination of ischemic and hemorrhagic strokes using a multiplexed, mass spectrometry-based assay for serum apolipoproteins coupled to multi-marker ROC algorithm
Article first published online: 25 APR 2012
© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim
PROTEOMICS - Clinical Applications
Volume 6, Issue 3-4, pages 190–200, April 2012
How to Cite
Lopez, M. F., Sarracino, D. A., Prakash, A., Athanas, M., Krastins, B., Rezai, T., Sutton, J. N., Peterman, S., Gvozdyak, O., Chou, S., Lo, E., Buonanno, F. and Ning, M. (2012), Discrimination of ischemic and hemorrhagic strokes using a multiplexed, mass spectrometry-based assay for serum apolipoproteins coupled to multi-marker ROC algorithm. Prot. Clin. Appl., 6: 190–200. doi: 10.1002/prca.201100041
- Issue published online: 25 APR 2012
- Article first published online: 25 APR 2012
- Accepted manuscript online: 4 JAN 2012 10:02AM EST
- Manuscript Accepted: 12 DEC 2011
- Manuscript Revised: 2 NOV 2011
- Manuscript Received: 6 JUN 2011
- Mass spectrometry
Typically, apolipoproteins are individually measured in blood by immunoassay. In this report, we describe the development of a multiplexed selected reaction monitoring (SRM) based assay for a panel of apolipoproteins and its application to a clinical cohort of samples derived from acute stroke patients.
An SRM assay for a panel of nine apolipoproteins was developed on a triple quadrupole mass spectrometer. Quantitative data for each apolipoprotein were analyzed to determine expression ratio and receiver operating characteristic (ROC) values for ischemic versus hemorrhagic stroke.
The optimized SRM assay was used to interrogate a small cohort of well-characterized plasma samples obtained from patients with acute ischemic and hemorrhagic strokes. The ROC analyses demonstrated good classification power for several single apolipoproteins, most notably apoC-III and apoC-I. When a novel multi-marker ROC algorithm was applied, the ischemic versus hemorrhagic groups were best differentiated by a combination of apoC-III and apoA-I with an area under the curve (AUC) value of 0.92.
Conclusions and clinical relevance
This proof-of-concept study provides interesting and provocative data for distinguishing ischemic versus hemorrhage within first week of symptom onset. However, the observations are based on one cohort of patient samples and further confirmation will be required.