Résumé
Background: Transient Ischaemic Attacks (TIAs) are a key predictor for ischaemic stroke but are difficult to distinguish from pathologies with similar symptoms, e.g. migraines, and seizures. Oxidative stress and associated lipid peroxidation pathways are also significant factors in ischaemic stroke and associated oxidative damage to the brain. Lipid peroxidation products, including prostaglandins, isoprostanes, and neuroprostanes, may therefore be potential diagnostic markers to distinguish TIA from minor strokes and TIA mimics.Aims: To identify prostaglandins, isoprostanes, neuroprostanes, and their metabolites that differentiate between TIAs, TIA mimics, and minor stroke diagnostic groups.Methods: Patients presenting with TIA-like symptoms were recruited at the Royal Adelaide Hospital (n=107). Plasma samples (<9mL) were collected within 48 hours of symptom onset and stored in line with HUPO guidelines. Prostanoids (n = 13) were obtained through SPE and analysed using LC-MS. Prostanoids with similar retention times as known standards were quantified. Untargeted peaks which did not share retention times with known standards were identified using Skyline. All patients were clinically classified independently as TIAs/TIA mimics/minor strokes by vascular neurologists.Results: 107 patients (57 Females, 50 Males) were enrolled with ages ranging from 39–94 years (Median: 72y). All patients were classified based on clinical data with 34% diagnosed as a TIA mimic. All prostanoids were observed, with untargeted peaks displaying differences between patients, with further data analysis underway.Conclusion: Preliminary findings from this study show that prostanoid analysis may differentiate between TIAs, TIA mimics, and minor strokes. The outcomes will be expanded to an untargeted dataset.