Glial fibrillary acidic protein concentrations strongly elevated in patients with intracerebral hemorrhage versus ischemic stroke, stroke mimics
By Elana Gotkine HealthDay Reporter
FRIDAY, Jan. 31, 2025 (HealthDay News) — Prehospital measurement of glial fibrillary acidic protein (GFAP) can rapidly differentiate intracerebral hemorrhage (ICH) from ischemic stroke (IS) and stroke mimics, according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 5 to 7 in Los Angeles.
Love-Preet Kalra, M.D., from RKH Hospital Klinikum Ludwigsburg in Germany, and colleagues examined the potential of a new GFAP point-of-care test for rapidly distinguishing ICH from IS and stroke mimics in the prehospital phase in a study enrolling 353 patients with acute stroke admitted within six hours of symptom onset. Blood samples were collected in the prehospital phase, and plasma GFAP measurements were performed (duration of analysis, 15 minutes). The final diagnosis at hospital discharge, categorized as ICH, IS, or stroke mimics, was used as the gold standard.
The researchers found that GFAP concentrations were strongly elevated in patients with ICH compared with patients with IS and stroke mimics (median, 208 pg/mL versus 30 and 48 pg/mL, respectively). Compared with non-anticoagulated patients, patients with anticoagulation-associated ICH had higher GFAP values. Cutoff points were ascertained, which facilitated ICH diagnosis across age groups with high positive predictive values (90.0 to 95.5 percent). In contrast, GFAP values below 30 pg/mL ruled out ICH with a negative predictive value of 100 percent in patients with a moderate-to-severe neurological deficit.
“It is crucial to differentiate these two types of stroke because they need opposite treatments,” Kalra said in a statement.
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