Acrolein and H2 O2 are among the metabolic products of spermine and spermidine, and it was found that acrolein was more toxic than H2 O2 . It was determined whether acrolein can serve as a biochemical marker for stroke (brain infarction) and chronic renal failure. Since acrolein rapidly reacts with lysine residues in protein, protein-conjugated acrolein (PC-Acro) was measured. PC-Acro was increased at the locus of brain infarction and in plasma in a mouse model of stroke involving photochemically induced thrombosis. An increase in PC-Acro in plasma was found to be a good biochemical marker in patients with stroke or with chronic renal failure. Using a receiver operating characteristic curve, the combined measurement of PC-Acro, IL-6 and CRP together with age indicated silent brain infarction (SBI) with 89% sensitivity and 91% specificity. The procedures to measure PC-Acro and polyamine oxidases [spermine oxidase (SMO) and acetylpolyamine oxidase (ACPAD)], and its application as markers in stroke and chronic renal failure are described in this chapter.