West Afr J Med. 2025 Jun 30;42(6):466-473.
ABSTRACT
BACKGROUND: Serum biomarkers, such as glial fibrillary acidic protein (GFAP), have been proposed to accurately assess stroke severity and prognosis. However, there is limited published data on their potential role in resource-limited settings where the stroke burden is highest.
OBJECTIVE: The study aims to determine the predictive value of the serum level of GFAP in assessing the severity and functional outcome of acute stroke.
METHOD: This prospective cohort study recruited forty consecutively presenting stroke subjects each for both ischaemic stroke and intracerebral haemorrhage at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife with forty apparently healthy controls. Serum concentrations of GFAP were measured using Enzyme-Linked Immunoassays, and the data were analyzed using Statistical Package for the Social Sciences software with significance at p<0.05.
RESULT: The median serum GFAP levels among apparently healthy controls, ischaemic stroke group and the ICH group at admission were 18.04 pg/ml, 24.10 pg/ml, and 33.33 pg/ml respectively. At admission, there was a significant difference in the median serum GFAP level in the ICH and apparently healthy control group as well as in the ischaemic stroke group and apparently healthy control group (p = 0.001). The study found no significant correlation between admission NIHSS and serum GFAP levels in both the ischaemic stroke group and the ICH group. In the ICH group, there was an inverse correlation between median serum GFAP level at day 7 and Barthel index at day 7 (p = 0.021) and day 30 (p = 0.001), but a positive correlation with modified Rankin score at day 30 (p = 0.001).
CONCLUSION: The study found that routine screening for serum GFAP level at admission in ischaemic stroke and ICH does not predict acute stroke severity and does not correlate with functional outcomes. However, Serum GFAP level at day 7 correlated with 30-day functional outcomes for ICH and its usefulness may be explored further in larger studies.
PMID:41252688
