Stroke Center, Taixing People's Hospital, Taixing, Jiangsu, People's Republic of China.
Department of Vascular Surgery, Taixing People's Hospital, Taixing, Jiangsu, People's Republic of China.
Clin Interv Aging. 2024 Jan 22;19:123-132. doi: 10.2147/CIA.S448180. eCollection 2024.
The correlation between glial fibrillary acidic protein (GFAP) and symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT) treatment remains uncertain. We aimed to assess the association between levels of GFAP in the bloodstream and the occurrence of sICH.
Between June 2019 and May 2023, 142 consecutive AIS patients undergoing EVT at Stroke Center and 35 controls from the Physical Examination Center were retrospectively included. The levels of GFAP in the bloodstream were quantified using enzyme-linked immunosorbent assay prior to endovascular treatment (T1) and 24 h after the procedure (T2). The identification of sICH was based on the Heidelberg Bleeding Classification.
Serum GFAP levels at T1 in AIS patients were significantly higher than those in the controls (0.249 [0.150-0.576] versus 0.065 [0.041-0.110] ng/mL, = 0.001), and there was a notably elevation in GFAP levels at T2 compared to T1 (3.813 [1.474, 5.876] versus 0.249 [0.150-0.576] ng/mL, = 0.001). Of the 142 AIS patients, 18 (14.5%) had sICH after EVT. Serum GFAP levels at T2 showed significant associations with sICH in both the unadjusted model (OR 1.513, 95% CI 1.269-1.805, = 0.001) and multivariable adjusted model (OR 1.518, 95% CI 1.153-2.000, = 0.003). Furthermore, the addition of GFAP at T2 to conventional model resulted in a significant enhancement of risk reclassification for sICH (integrated discrimination improvement [IDI] 0.183, 95% CI 0.070-0.295, = 0.001).
Serum GFAP levels were notably increased in AIS patients 24 h after EVT. Elevated GFAP levels were correlated to an elevated risk of sICH. GFAP could potentially serve as a dependable indicator for sICH in AIS individuals who treated with EVT.
在接受血管内血栓切除术（EVT）治疗的急性缺血性脑卒中（AIS）患者中，胶质纤维酸性蛋白（GFAP）与症状性颅内出血（sICH）之间的相关性仍不确定。我们旨在评估血流中 GFAP 水平与 sICH 发生之间的关系。
回顾性纳入 2019 年 6 月至 2023 年 5 月期间在卒中中心接受 EVT 的 142 例连续 AIS 患者和体检中心的 35 例对照。在血管内治疗前（T1）和术后 24 小时（T2）使用酶联免疫吸附试验定量测定血液中的 GFAP 水平。sICH 的鉴定基于海德堡出血分类。
AIS 患者 T1 时血清 GFAP 水平明显高于对照组（0.249 [0.150-0.576] 与 0.065 [0.041-0.110]ng/mL， = 0.001），且 T2 时 GFAP 水平明显高于 T1（3.813 [1.474, 5.876] 与 0.249 [0.150-0.576]ng/mL， = 0.001）。142 例 AIS 患者中，18 例（14.5%）在 EVT 后发生 sICH。T2 时血清 GFAP 水平在未调整模型（OR 1.513，95%CI 1.269-1.805， = 0.001）和多变量调整模型（OR 1.518，95%CI 1.153-2.000， = 0.003）中均与 sICH 显著相关。此外，将 T2 时的 GFAP 添加到常规模型中可显著提高 sICH 的风险再分类（综合判别改善 [IDI] 0.183，95%CI 0.070-0.295， = 0.001）。
EVT 后 24 小时，AIS 患者血清 GFAP 水平明显升高。升高的 GFAP 水平与 sICH 风险增加相关。GFAP 可能成为接受 EVT 治疗的 AIS 患者 sICH 的可靠指标。
