title: Comparison of plasma beta-globin DNA and S-100 protein concentrations in acute stroke.
abstract: BACKGROUND
  This study aimed to compare changes in plasma beta-globin DNA and serum S100 protein to diagnose stroke and for predicting mortality and morbidity.
  
  
  METHODS
  Patients with stroke-like symptoms presenting to the emergency department of a Hong Kong hospital were recruited. Plasma DNA was analyzed for the beta-globin gene with fluorescent-based PCR. S100 concentrations were determined using ELISA. Primary outcomes were diagnosis of stroke, mortality, and modified Rankin Score (mRS) after 6 months.
  
  
  RESULTS
  One hundred ninety-seven consecutive patients recruited, 118 (60%) ischemic stroke, 35 (18%) hemorrhage and 44 (22%) with no acute neuroimaging changes. Serum S100 and plasma DNA were increased in 126 (p<0.0010) and 36 (p=0.21) stroke patients respectively vs. controls. Median plasma DNA was higher in hemorrhagic stroke than those without (1725 vs. 1050 kilogenome-equivalents/l, p=0.0104). Median plasma DNA was higher in mRS>2 vs. mRS<or=2 (1350 vs. 1025, p=0.0103), and higher in non-survivors vs. survivors (1625 vs. 1050, p=0.0070). Median serum S100 higher in mRS>2 patients vs. mRS<or=2 (0.152 vs. 0.131 microg/l, p=0.0003). The odds ratio (OR) of discriminating hemorrhagic from non-hemorrhagic stroke with DNA was 4.24 (95% CI 1.88-9.56); S100 and DNA together give an OR of 16.55.
  
  
  CONCLUSIONS
  For stroke diagnosis, S100 performs better than DNA; DNA is a better marker for hemorrhage. For diagnosis of hemorrhagic stroke, combined S100 and DNA performs better than either alone. Plasma DNA and serum S100 predict morbidity and mortality in stroke.
authors.affiliation: Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Rainer
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
authors.forename: Wynnie
authors.initials: W
authors.lastname: Lam
authors.forename: Nicole Y L
authors.initials: NY
authors.lastname: Lam
authors.forename: Colin A
authors.initials: CA
authors.lastname: Graham
authors.forename: Y M Dennis
authors.initials: YM
authors.lastname: Lo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D004247:DNA / Q000097:blood* / Q000235:genetics; D005260:Female; D005914:Globins / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D009418:S100 Proteins / Q000097:blood*; D020521:Stroke / Q000097:blood* / Q000175:diagnosis*
chemical_list: D009418:S100 Proteins; D005914:Globins; D004247:DNA