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International Journal of Vascular Medicine
Volume 2012, Article ID 906954, 6 pages
Clinical Study

Evaluation of Serum Biomarkers for Patients at Increased Risk of Stroke

1Clinic of Vascular Surgery, Klinikum Rechts der Isar der Technischen Universitaet Muenchen, Ismaninger Straße 22, 81675 Munich, Germany
2Department of Neurology, Klinikum Rechts der Isar der Technischen Universitaet Muenchen, Germany

Received 30 September 2011; Revised 6 January 2012; Accepted 6 January 2012

Academic Editor: Karl A. Illig

Copyright © 2012 Pelisek Jaroslav et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Early recognition of vulnerable patients is an important issue for stroke prevention. In our study, a multiscore analysis of various biomarkers was performed to evaluate its superiority over the analysis of single factors. Study subjects ( 𝑛 = 1 1 0 ) were divided into four groups: asymptomatic patients with stable ( 𝑛 = 2 5 ) and unstable ( 𝑛 = 3 6 ) plaques and symptomatic patients with stable ( 𝑛 = 1 3 ) and unstable ( 𝑛 = 3 6 ) plaques. Serum levels of MMP-1, -2, -3, -7, -8, -9, TIMP-1, -2, TNF-α, IL-1b, and IL-6, -8, -10, -12 were measured. Multi-score analysis was performed using multiple receiver operating characteristics (ROC) and determination of appropriate cutoff values. Significant differences between the groups were observed for MMP-1, -7, -9 and TIMP-1 in serum of the study subjects ( 𝑃 < 0 . 0 5 ). Multiple biomarker analysis led to a significant increase in the AUC (area under curve). In case of plaque instability, positive predictive value (PPV) for up to 86.4% could be correctly associated with vulnerable plaques. Thus, multiscore analysis might be preferable than the use of single biomarkers.