Ultra-Early Differential Diagnosis of Acute Cerebral Ischemia and Hemorrhagic Stroke by Measuring the Prehospital Release Rate of GFAP

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Search: id:"swepub:oai:gup.ub.gu.se/310001" > Ultra-Early Differe...

1 of 1
Previous record
Next record
To hitlist

Ultra-Early Differential Diagnosis of Acute Cerebral Ischemia and Hemorrhagic Stroke by Measuring the Prehospital Release Rate of GFAP

Mattila, O. S. (author)

Ashton, Nicholas J. (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry

Blennow, Kaj, 1958 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry

Zetterberg, Henrik, 1973 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry

Harve-Rytsala, H. (author)

Pihlasviita, S. (author)

Ritvonen, J. (author)

Sibolt, G. (author)

Nukarinen, T. (author)

Curtze, S. (author)

Strbian, D. (author)

Pystynen, M. (author)

Tatlisumak, Turgut (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology

Kuisma, M. (author)

Lindsberg, P. J. (author)

show less...

(creator_code:org_t)

2021-08-12
2021
English.
In: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 67:10, s. 1361-1372

Related links:: https://academic.oup...; show more...; https://gup.ub.gu.se...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: Plasma glial fibrillary acidic protein (GFAP) and tau are promising markers for differentiating acute cerebral ischemia (ACI) and hemorrhagic stroke (HS), but their prehospital dynamics and usefulness are unknown. METHODS: We performed ultra-sensitivite single-molecule array (Simoa((R))) measurements of plasma GFAP and total tau in a stroke code patient cohort with cardinal stroke symptoms [National Institutes of Health Stroke Scale (NIHSS) >= 3]. Sequential sampling included 2 ultra-early samples, and a follow-up sample on the next morning. RESULTS: We included 272 cases (203 ACI, 60 HS, and 9 stroke mimics). Median (IQR) last-known-well to sampling time was 53 (35-90) minutes for initial prehospital samples, 90 (67-130) minutes for secondary acute samples, and 21 (16-24) hours for next morning samples. Plasma GFAP was significantly higher in patients with HS than ACI (P<0.001 for <1hour and <3hour prehospital samples, and <3hour secondary samples), while total tau showed no intergroup difference. The prehospital GFAP release rate (pg/mL/minute) occurring between the 2 very early samples was significantly higher in patients with HS than ACI [2.4 (0.6-14.1)] versus 0.3 (-0.3-0.9)pg/mL/minute, P<0.001. For cases with <3hour prehospital sampling (ACI n=178, HS n=59), a combined rule (prehospital GFAP >410pg/mL, or prehospital GFAP 90-410pg/mL together with GFAP release >0.6pg/mL/minute) enabled ruling out HS with high certainty (NPV 98.4%) in 68% of patients with ACI (sensitivity for HS 96.6%, specificity 68%, PPV 50%). CONCLUSIONS: In comparison to single-point measurement, monitoring the prehospital GFAP release rate improves ultra-early differentiation of stroke subtypes. With serial measurement GFAP has potential to improve future prehospital stroke diagnostics.

Subject headings

NATURVETENSKAP -- Kemi (hsv//swe)
NATURAL SCIENCES -- Chemical Sciences (hsv//eng)

Keyword

stroke
EMS
biomarker
GFAP
tau
fibrillary acidic protein
intracerebral hemorrhage
blood biomarkers
management
triage
scale
Medical Laboratory Technology

Publication and Content Type

ref (subject category)
art (subject category)

Find in a library

Clinical Chemistry (Search for host publication in LIBRIS)

To the university's database

1 of 1
Previous record
Next record
To hitlist

Find more in SwePub

By the author/editor: Mattila, O. S.; Ashton, Nicholas ...; Blennow, Kaj, 19 ...; Zetterberg, Henr ...; Harve-Rytsala, H ...; Pihlasviita, S.; show more...; Ritvonen, J.; Sibolt, G.; Nukarinen, T.; Curtze, S.; Strbian, D.; Pystynen, M.; Tatlisumak, Turg ...; Kuisma, M.; Lindsberg, P. J.; show less...

About the subject

NATURAL SCIENCES: NATURAL SCIENCES; and Chemical Science ...

Articles in the publication: Clinical Chemist ...

By the university: University of Gothenburg

Search outside SwePub

Extend your search to:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se