Acta Neurol Belg. 2023 Sep 4. doi: 10.1007/s13760-023-02372-1. Online ahead of print.
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.