Abstract WP313: Towards Molecular Profiling of Transient Ischemic Attack Mimics for Triage

Abstract

Peripheral blood gene expression profiles can distinguish ischemic stroke from intracerebral hemorrhage and controls. However, it can be difficult to clinically distinguish “mimics” of transient ischemic attacks (TIA) and minor strokes from true TIAs and minor strokes. Even with imaging this can be a challenging differential diagnosis in the ED and other acute settings. Hence, there is a need for defining a molecular profile from blood that could guide triage of TIA mimics to reduce ED burden. This multi-site project collected peripheral blood from the participants and generated gene-level data from RNA sequencing. The cohort was composed of patients with a) TIA mimic presentation (n= 142 TIA mimics: an acute onset of neurological symptoms lasting <24h, that can be explained by some identifiable process other than cerebral ischemia including migraine, seizure, peripheral vestibular disease, brain tumors, syncope, root or peripheral nerve disease, and others); b) patients with transient ischemic attacks (n= 181 TIA: acute onset of neurological symptoms and signs that last <24h with a likely underlying cause of either large vessel atherosclerosis or cardioembolic origin but with a negative brain DWI-MRI); c) controls (n= 172 VRFC: no acute brain event, usually with one or more vascular risk factors including diabetes, hypertension or hypercholesterolemia). Differential expression (DE) analyses (fold change >