Heart - type fatty acid binding protein in prognosis of ischemic stroke at the hospital stage


Cite item

Full Text

Abstract

Heart - type fatty acid binding protein (h-FABP), in addition to myocardium, is also contained in the brain cells. The blood concentration of h-FABP in cerebral ischemia can be a marker of ischemic stroke course. Aim. To investigate the importance of h-FABP in the prognosis of ischemic stroke (IS). Materials and methods. The study included 302 patients in the acute period of ischemic stroke. All patients were determined the concentration of h-FABP in the serum 1 day by enzyme immunoassay. SPSS and Microsoft Excel software were used for statistical data processing. Results. The most frequent adverse events at the hospital stage were lethal outcome (LO), thrombotic complications and pneumonia. Statistically significant differences in the level of h-FABP between the groups of presence and absence of LO were revealed both by confidence intervals of Central values and by statistical criteria. The ROC analysis values of h-FABP in the presence of the LO confirmed its predictive value, area under the curve amounted to 0.776±0.061 (0.655-0.896), p<0.001. The calculated threshold value of h-FABP was 2757 pg/ml with a sensitivity of 80% and specificity of 74.4%. Prognostic value of a positive result of h-FABP in the prediction of LO was 71%, the negative predictive value of the result is 83%. Odds ratio LO the threshold value of h-FABP was 11.6 (3.68-36.5). Conclusion. Results of the study showed that h-FABP is a significant laboratory biomarker in the prediction of lethal outcome in patients with ischemic stroke. In the absence of any statistically significant effect on the concentration of h-FABP the treatment modality, causes of death and cardiovascular diseases in anamnesis increase the concentration of h-FABP above the threshold 2757 pg/ml can be considered an independent risk factor lethal outcome patients with ischemic stroke.

About the authors

O V Lyang

Federal Center for Cerebrovascular Pathology and Stroke; Peoples Friendship University of Russia (RUDN University)

Moscow, Russia

A G Kochetov

Institute of Laboratory Medicine; National Medical Research Center of Cardiology

Moscow, Russia

I A Zhirova

Peoples Friendship University of Russia (RUDN University)

Moscow, Russia

Yu V Novozhenova

Peoples Friendship University of Russia (RUDN University)

Moscow, Russia

O O Ivoylov

National Medical Research Center of Cardiology

Moscow, Russia

L V Stakhovskaya

Pirogov Russian National Research Medical University

Moscow, Russia

References

  1. Kleine A.H, Glatz J.F, van Nieuwenhoven F.A. Release of heart fatty acid - binding protein after acute myocardial infarction in man. Mol Cell Biochem. 1992;116:155-62. doi: 10.1007/978-1-4615-3514-0_22
  2. Tanaka T, Hirota Y, Sohmiya K, Nishimura S, Kawamura K. Serum and urinary human heart fatty acid - binding protein in acute myocardial infarction. Clin Biochem. 1991;24(2):195-201. doi: 10.1016/0009- 9120(91)90571-u
  3. Lescuyer P, Allard L, Hochstrasser D. Heart - fatty acid - binding protein as a marker for early detection of acute myocardial infarction and stroke. Mol Diagn. 2005;9(1):1-7. doi: 10.2165/00066982-200509010-00001
  4. Park S.Y, Kim M.H, Kim O.J. 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. 2013;4:405-10. doi: 10.1016/j.clineuro.2012.06.004
  5. Wunderlich M.T, Hanhoff T, Goertler M. Release of brain - type and heart - type fatty acid - binding proteins in serum after acute ischaemic stroke. J Neurol. 2005;6:718-24. doi: 10.1007/s00415-005-0725-z
  6. Стаховская Л.В., Котов С.В., ред. Инсульт: Руководство для врачей. М.: МИА, 2014. 400 с.
  7. Ершов В.И., Сафронов Е.Ю., Чирков А.Н. Осложненный ишемический инсульт: течение и прогноз. Оренбургский медицинский вестник. 2016;(1):14-7.
  8. Кутлубаев М.А. Инфекционно - воспалительные осложнения церебрального инсульта. Клиническая медицина. 2014;(10):66-72.
  9. Рябинкина Ю.В., Гнедовская Е.В., Максимова М.Ю. и др. Инсульт: частота развития и факторы риска венозных тромбоэмболических осложнений в условиях отделения реанимации и интенсивной терапии. Анестезиология и реаниматология. 2015;(5):54-9.
  10. Юнгехюльзинг Г.Я., Эндрес М., ред. Осложнения и последствия инсультов. Диагностика и лечение ранних и поздних нарушений функции. Пер. с нем. под ред. Л.В. Стаховской. М.: МЕДпресс - информ, 2017. 264 с.
  11. Altman D.J, Gore S.M, Gardner M.J. Statistical guidelines for contributors to medical journals. Br Med J (Clin Res Ed). 1983;6376:1489-93. doi: 10.1136/bmj.287.6385.132-b
  12. Ланг Т.А., Сесик М. Описание статистики в медицине. Руководство для авторов, редакторов и рецензентов. М.: Практическая медицина, 2011. 477 c.
  13. Бударова К.В., Шмаков А.Н., Сирота С.И. Возможности ROC-анализа в интенсивной терапии новорожденных. Здоровье и образование в XXI веке. Журнал научных статей. 2017;(6):88-93. doi: 10.26787/nydha-2226-7425-2017-19-6-88-92
  14. Tirawanish P, Eamsobhana P. Prediction of Callus Subsidence in Distraction Osteogenesis Using Callus Formation Scoring System: Preliminary Study. Orthop Surg. 2018;2:121-7. doi: 10.1111/os.12374
  15. Dell R.B, Holleran S, Ramakrishnan R. Sample Size Determination. ILAR J. 2002;43-44:207-13. doi: 10.1093/ilar.43.4.207
  16. Стародубцева О.С., Бегичева С.В. Анализ заболеваемости инсультом с использованием информационных технологий. Фундаментальные исследования. 2012;(8-2):424-7.
  17. Методические рекомендации по способам оплаты медицинской помощи за счет средств обязательного медицинского страхования. М., 2018. 81 с.

Copyright (c) 2019 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies