NR2 antibodies: Risk assessment of transient ischemic attack (TIA)/stroke in patients with history of isolated and multiple cerebrovascular events

Background and purpose: Predicting stroke using biomarkers would enable clinicians to help prevent stroke or mitigate damage. Several stroke biomarkers have been investigated but none has shown near term predictive value. Methods: We studied patients presenting with a history of stroke or transient ischemic attack (TIA) to determine whether serum levels of autoantibodies to the NMDA receptor NR2 peptide (NR2Ab) reflected the presence of recent stroke compared with controls. Antibody levels were also correlated with clinical risk factors for stroke, including diabetes, hypertension, hyperlipidemia, and history of recent TIA or stroke. Results: Of the 245 patients that presented with acute stroke or TIA, 130 consented to participate and results are available for the 120. Volunteers from the community were recruited as controls. Males and females with multiple recent strokes and females with acute strokes had elevated NR2Ab levels compared to non-stroke patients or controls. Using a multiple regression model, the predictive value for NR2Ab was compared to clinical risk factors. In men, the presence of stroke correlated with hypertension (p<0.001) and NR2Ab levels (p<0.01) and in women the presence of stroke correlated with hypertension (p<0.001), diabetes (p<0.05), atrial fibrillation (p<0.05) and NR2Ab (p<0.01). Conclusion: These results suggest that NR2Ab levels reflect a history of multiple strokes and may serve as a predictive factor for stroke. (c) 2010 Elsevier B.V. All rights reserved.