PMID- 32907910
OWN - NLM
STAT- MEDLINE
DCOM- 20210929
LR  - 20210929
IS  - 1708-8267 (Electronic)
IS  - 1081-5589 (Linking)
VI  - 68
IP  - 8
DP  - 2020 Dec
TI  - Discriminative value of glial fibrillar acidic protein (GFAP) as a diagnostic 
      tool in acute stroke. Individual patient data meta-analysis.
PG  - 1379-1385
LID - 10.1136/jim-2020-001432 [doi]
AB  - Glial fibrillar acidic protein (GFAP) in serum has been evaluated as a promising 
      biomarker to differentiate between intracerebral hemorrhage (ICH) and acute 
      ischemic stroke (AIS). We assessed its value as diagnostic and prognostic tool 
      for ICH through a literature systematic review and individual patient data (IPD) 
      meta-analysis.We performed a systematic search in PubMed database until November 
      2018 for publications that evaluated GFAP to differentiate AIS and ICH within 4.5 
      hours after symptoms onset. Thereafter, we invited authors of selected studies to 
      participate in this work by providing IPD from their cohorts. We used 
      standardized individual subject's data to evaluate the association of GFAP 
      concentrations with stroke subtype, demographics, stroke characteristics and 
      factors related with GFAP measurement.From 4 selected studies, we collected data 
      of 340 patients (236 AIS and 104 ICH). Standardized GFAP blood levels were 
      significantly elevated in ICH compared with those with AIS (median and IQR: 0.84 
      (0.781-1.24), 0.79 (0.74-0.81); p<0.0001). In both stroke types, GFAP 
      concentrations correlated with baseline stroke severity (r=0.27, p<0.0001; 
      r=0.36, p<0.001; for AIS and ICH, respectively) but no correlation was found 
      regarding time to sampling. Limited data precluded the evaluation of GFAP levels 
      and functional outcome.These findings demonstrate substantially different levels 
      of GFAP in the blood of patients with ICH compared with patients with AIS soon 
      after the event, while no association was found with outcome. In summary, GFAP 
      could be a valuable diagnostic tool to assist in medical decision-making and to 
      optimize management of stroke in the acute setting.
CI  - (c) American Federation for Medical Research 2020. No commercial re-use. See rights 
      and permissions. Published by BMJ.
FAU - Cabezas, Juan Antonio
AU  - Cabezas JA
AUID- ORCID: 0000-0001-9035-4643
AD  - Neurology, Virgen del Rocio University Hospital, Sevilla, Spain.
FAU - Bustamante, Alejandro
AU  - Bustamante A
AD  - Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), 
      Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Giannini, Nicola
AU  - Giannini N
AD  - Neurological Clinic, University of Pisa, Pisa, Italy.
FAU - Pecharroman, Emilio
AU  - Pecharroman E
AD  - Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), 
      Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Katsanos, Aristeidis H
AU  - Katsanos AH
AD  - Department of Neurology, University of Ioannina School of Medicine, Athens, 
      Greece.
FAU - Tsivgoulis, Georgios
AU  - Tsivgoulis G
AD  - Department of Neurology, School of Medicine, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Rozanski, Michal
AU  - Rozanski M
AD  - Department of Neurology, Center for Stroke Research Berlin (CSB), 
      Charite-Universitatsmedizin, Berlin, Germany.
FAU - Audebert, Heinrich
AU  - Audebert H
AD  - Department of Neurology, Center for Stroke Research Berlin (CSB), 
      Charite-Universitatsmedizin, Berlin, Germany.
FAU - Mondello, Stefania
AU  - Mondello S
AD  - Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, 
      University of Messina, Messina, Italy.
FAU - Llombart, Victor
AU  - Llombart V
AD  - Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), 
      Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Montaner, Joan
AU  - Montaner J
AD  - Neurology, Virgen Macarena University Hospital, Sevilla, Spain 
      jmontaner-ibis@us.es.
AD  - Neurovascular Laboratory, Vall d'Hebron Hospital, Barcelona, Spain.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20200908
PL  - England
TA  - J Investig Med
JT  - Journal of investigative medicine : the official publication of the American 
      Federation for Clinical Research
JID - 9501229
RN  - 0 (Glial Fibrillary Acidic Protein)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cerebral Hemorrhage/blood/diagnosis
MH  - Cohort Studies
MH  - Diagnosis, Differential
MH  - Female
MH  - Glial Fibrillary Acidic Protein/*blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Publication Bias
MH  - Stroke/*blood/*diagnosis
MH  - Treatment Outcome
OTO - NOTNLM
OT  - biomarkers
OT  - stroke
COIS- Competing interests: None declared.
EDAT- 2020/09/11 06:00
MHDA- 2021/09/30 06:00
CRDT- 2020/09/10 05:29
PHST- 2020/08/04 00:00 [accepted]
PHST- 2020/09/11 06:00 [pubmed]
PHST- 2021/09/30 06:00 [medline]
PHST- 2020/09/10 05:29 [entrez]
AID - jim-2020-001432 [pii]
AID - 10.1136/jim-2020-001432 [doi]
PST - ppublish
SO  - J Investig Med. 2020 Dec;68(8):1379-1385. doi: 10.1136/jim-2020-001432. Epub 2020 
      Sep 8.