Abstract
Background
Heart-type fatty acid-binding protein (HFABP) is found in the myocardium, brain, and some organs and is rapidly released from damaged cells into the circulation in case of ischemia.
Aims
We aimed to determine the diagnostic utility of HFABP levels in patients suggesting acute ischemic stroke (AIS).
Methods
This study was a prospective, single-center, observational diagnostic accuracy study with a nested cohort design. The estimated sample size was 126 patients, with a 1:1 case and control ratio. We included all consecutive patients with a lateralizing symptom (motor or sensory) or finding suggesting AIS (139 patients) who presented to ED within 24 h of their symptom onset and collected plasma at admission to the ED. After further evaluations, 111 patients (79.8%) were diagnosed with AIS and 28 with other neurological diseases (stroke-mimics).
Findings
In our study, the median HFABP levels of the cases and controls were 2.6 μg/ml and 2.2 μg/ml, respectively, without any statistically significant difference (p = 0.120). The diagnostic accuracy of HFABP for AIS was also insignificant at 0.60 (95% CI 0.51–0.68; p = 0.119).
Discussion
Plasma HFABP level is not a marker that can differentiate AIS from other neurological pathologies in patients presenting to the ED, with findings suggesting AIS.
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Data availability
Data will be made available on request.
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Acknowledgements
We want to thank Omer Faruk Tekin, MD, and Marmara University School of Medicine, Department of Biochemistry, for helping with sample preparation and ELISA testing.
Funding
This study was supported by Marmara University Scientific Research Projects Unit within the scope of Project SAG-C-TUP-110718-0441.
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E.U.: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Validation, Roles/Writing—original draft, Writing—review & editing; H.A.: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Software, Supervision, Validation, Roles/Writing—original draft, Writing—review & editing; E.S., S.K.: Resources, Supervision, Validation, Writing—review & editing; M.E.S.: Investigation, Project administration, Resources, Supervision; O.O.: Conceptualization, Methodology, Project administration, Supervision, Validation, Writing—review & editing; A.D.: Conceptualization, Methodology, Project administration, Supervision, Validation, Writing—review & editing. All authors were involved with the organization/supervision of the article; contributed to the analysis of data, interpretation of the data, drafting/writing of the manuscript; and reviewed/approved the final version to be published. EU takes responsibility for the paper as a whole.
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The Ethics Committee approved this study of the Marmara University School of Medicine in September 2016 with the Approval No. 09.2016.297.
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Unal, E., Akoglu, H., Sanri, E. et al. The utility of heart-type free fatty-acid binding-protein (HFABP) levels for differentiating acute ischemic stroke from stroke mimics. Acta Neurol Belg 124, 183–191 (2024). https://doi.org/10.1007/s13760-023-02372-1
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DOI: https://doi.org/10.1007/s13760-023-02372-1