Love-Preet Kalra, Himani Khatter, Sarvotham Ramanathan, Sameer Sapehia, Kavita Devi, Abirami Kaliyaperumal, Deepti Bal, Ivy Sebastian, Raviteja Kakarla, Anusha Singhania, Shubhra Rathore, Svenja Klinsing, Jeyaraj Durai Pandian, Christian Förch
- Introduction: Despite a high burden of stroke, access to rapid brain imaging is limited in many middle- and low-income countries. Previous studies have described the astroglial protein GFAP (glial fibrillary acidic protein) as a biomarker of intracerebral hemorrhage. The aim of this study was to test the diagnostic accuracy of GFAP for ruling out intracranial hemorrhage in a prospective cohort of Indian stroke patients. Patients and methods: This study was conducted in an Indian tertiary hospital (Christian Medical College, Ludhiana). Patients with symptoms suggestive of acute stroke admitted within 12 h of symptom onset were enrolled. Blood samples were collected at hospital admission. Single Molecule Array technology was used for determining serum GFAP concentrations. Results: A total number of 155 patients were included (70 intracranial hemorrhage, 75 ischemic stroke, 10 stroke mimics). GFAP serum concentrations were elevated in intracranial hemorrhage patients compared to ischemic stroke patients [median (interquartile range) 2.36 µg/L (0.61–7.16) vs. 0.18 µg/L (0.11–0.38), p < 0.001]. Stroke mimics patients had a median GFAP serum level of 0.14 µg/L (0.09–0.26). GFAP values below the cut-off of 0.33 µg/L (area under the curve 0.871) ruled out intracranial hemorrhage with a negative predictive value of 89.7%, (at a sensitivity for detecting intracranial hemorrhage of 90.0%). Discussion: The high negative predictive value of a GFAP test system allows ruling out patients with intracranial hemorrhage. Conclusion: In settings where immediate brain imaging is not available, this would enable to implement secondary prevention (e.g., aspirin) in suspected ischemic stroke patients as soon as possible.
MetadatenAuthor: | Love-Preet Kalra, Himani Khatter, Sarvotham Ramanathan, Sameer Sapehia, Kavita Devi, Abirami Kaliyaperumal, Deepti Bal, Ivy Sebastian, Raviteja Kakarla, Anusha Singhania, Shubhra Rathore, Svenja Klinsing, Jeyaraj Durai Pandian, Christian FörchORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-624983 |
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DOI: | https://doi.org/10.1177/23969873211010069 |
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ISSN: | 2396-9881 |
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Parent Title (English): | European stroke journal |
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Publisher: | Sage Publishing |
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Place of publication: | London |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2021/05/11 |
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Date of first Publication: | 2021/05/11 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2021/11/22 |
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Tag: | GFAP; biomarker; diagnostic method; glial fibrillary acidic protein; intracerebral hemorrhage; intracranial hemorrhage; ischemic stroke |
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Volume: | 6 |
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Issue: | 2 |
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Page Number: | 9 |
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First Page: | 176 |
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Last Page: | 184 |
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Note: | The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Department of Neurology, Goethe University, Frankfurt am Main, Germany. |
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HeBIS-PPN: | 489175813 |
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Institutes: | Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (English): | Creative Commons - Namensnennung-Nicht kommerziell 4.0 |
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