Skip to main content

Advertisement

SpringerLink
Log in

The utility of heart-type free fatty-acid binding-protein (HFABP) levels for differentiating acute ischemic stroke from stroke mimics

  • Original article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data will be made available on request.

References

  1. Payne S (2018) Cerebral blood flow and metabolism: a quantitative approach. Accessed: 29 Oct 2021. http://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&db=nlabk&AN=1632316

  2. Virani SS et al (2021) Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation 143(8):e254–e743. https://doi.org/10.1161/CIR.0000000000000950

    Article  PubMed  Google Scholar 

  3. Béjot Y et al (2014) Trends in the incidence of ischaemic stroke in young adults between 1985 and 2011: the Dijon Stroke Registry. J Neurol Neurosurg Psychiatry 85(5):509–513. https://doi.org/10.1136/jnnp-2013-306203

    Article  PubMed  Google Scholar 

  4. Oliveira-Filho J, Mullen M (2021) Initial assessment and management of acute stroke—UpToDate, UpToDate, 05 March 2021. https://e1c9b1a9cc9b2679354d789c7627a4c889c411cc.vetisonline.com/contents/initial-assessment-and-management-of-acute-stroke?search=stroke%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Accessed 29 Oct 2021

  5. Büttner T, Weyers S, Postert T, Sprengelmeyer R, Kuhn W (1997) S-100 protein: serum marker of focal brain damage after ischemic territorial MCA infarction. Stroke 28(10):1961–1965. https://doi.org/10.1161/01.STR.28.10.1961

    Article  PubMed  Google Scholar 

  6. Nguyen HC, Qadura M, Singh KK (2020) Role of the fatty acid binding proteins in cardiovascular diseases: a systematic review. J Clin Med 9(11):E3390. https://doi.org/10.3390/jcm9113390

    Article  CAS  Google Scholar 

  7. Furuhashi M, Fucho R, Görgün CZ, Tuncman G, Cao H, Hotamisligil GS (2008) Adipocyte/macrophage fatty acid-binding proteins contribute to metabolic deterioration through actions in both macrophages and adipocytes in mice. J Clin Invest 118(7):2640–2650. https://doi.org/10.1172/JCI34750

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Chmurzyńska A (2006) The multigene family of fatty acid-binding proteins (FABPs): function, structure and polymorphism. J Appl Genet 47(1):39–48. https://doi.org/10.1007/BF03194597

    Article  PubMed  Google Scholar 

  9. Pelsers MMAL et al (2004) Brain- and heart-type fatty acid-binding proteins in the brain: tissue distribution and clinical utility. Clin Chem 50(9):1568–1575. https://doi.org/10.1373/clinchem.2003.030361

    Article  CAS  PubMed  Google Scholar 

  10. Lescuyer P et al (2004) Identification of post-mortem cerebrospinal fluid proteins as potential biomarkers of ischemia and neurodegeneration. Proteomics 4(8):2234–2241. https://doi.org/10.1002/pmic.200300822

    Article  CAS  PubMed  Google Scholar 

  11. Olsson B et al (2016) CSF and blood biomarkers for the diagnosis of Alzheimer’s disease: a systematic review and meta-analysis. Lancet Neurol 15(7):673–684. https://doi.org/10.1016/S1474-4422(16)00070-3

    Article  CAS  PubMed  Google Scholar 

  12. Zhang H-W et al (2020) Heart-type fatty acid binding protein predicts cardiovascular events in patients with stable coronary artery disease: a prospective cohort study. Ann Transl Med 8(21):1349. https://doi.org/10.21037/atm-20-2493

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Lyang OV, Kochetov AG, Zhirova IA, Novozhenova YV, Ivoylov OO, Stakhovskaya LV (2019) Heart—type fatty acid binding protein in prognosis of ischemic stroke at the hospital stage. Ter Arkh 91(12):35–40. https://doi.org/10.26442/00403660.2019.12.000469

    Article  CAS  PubMed  Google Scholar 

  14. Lagerstedt L et al (2018) Combining H-FABP and GFAP increases the capacity to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury. PLoS ONE 13(7):e0200394. https://doi.org/10.1371/journal.pone.0200394

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Dolmans LS et al (2019) Serum biomarkers in patients suspected of transient ischaemic attack in primary care: a diagnostic accuracy study. BMJ Open 9(10):e031774. https://doi.org/10.1136/bmjopen-2019-031774

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cohen JF et al (2016) STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration. BMJ Open 6(11):e012799. https://doi.org/10.1136/bmjopen-2016-012799

    Article  PubMed  PubMed Central  Google Scholar 

  17. Vera MA, Koch CD, Kavsak PA, El-Khoury JM (2021) Determination of 97.5th and 99th percentile upper reference limits for heart-type fatty acid-binding protein (H-FABP) in a US population. Clin Chim Acta 523:397–401. https://doi.org/10.1016/j.cca.2021.10.011

    Article  CAS  PubMed  Google Scholar 

  18. Wunderlich MT et al (2005) Release of brain-type and heart-type fatty acid-binding proteins in serum after acute ischaemic stroke. J Neurol 252(6):718–724. https://doi.org/10.1007/s00415-005-0725-z

    Article  CAS  PubMed  Google Scholar 

  19. Zimmermann-Ivol CG, Burkhard PR, Le Floch-Rohr J, Allard L, Hochstrasser DF, Sanchez J-C (2004) Fatty acid binding protein as a serum marker for the early diagnosis of stroke: a pilot study. Mol Cell Proteomics 3(1):66–72. https://doi.org/10.1074/mcp.M300066-MCP200

    Article  CAS  PubMed  Google Scholar 

  20. Park S-Y et al (2013) Plasma heart-type fatty acid binding protein level in acute ischemic stroke: comparative analysis with plasma S100B level for diagnosis of stroke and prediction of long-term clinical outcome. Clin Neurol Neurosurg 115(4):405–410. https://doi.org/10.1016/j.clineuro.2012.06.004

    Article  PubMed  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Marmara Universitesi Pendik Egitim ve Arastirma Hastanesi, Marmara University School of Medicine, Istanbul, Turkey

    Emir Unal, Haldun Akoglu, Erkman Sanri, Sinan Karacabey, Melis Efeoglu Sacak, Ozge Onur & Arzu Denizbasi

Authors
  1. Emir Unal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Haldun Akoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erkman Sanri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sinan Karacabey
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Melis Efeoglu Sacak
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ozge Onur
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Arzu Denizbasi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

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.

Corresponding author

Correspondence to Emir Unal.

Ethics declarations

Conflict of interest

The authors report no conflict of interest.

Ethical approval

The Ethics Committee approved this study of the Marmara University School of Medicine in September 2016 with the Approval No. 09.2016.297.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-023-02372-1

Keywords

Search

Navigation