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P.044 The impact of working hours on rapid GFAP measurement in acute stroke: evaluation of sampling bias in an ongoing prospective study

Published online by Cambridge University Press:  10 July 2025

Y Bairi
Affiliation:
(Montreal)*
C Brassard
Affiliation:
(Montreal)
J Paul
Affiliation:
(Montreal)
M Sayed
Affiliation:
(Montreal)
C Margarido
Affiliation:
(Montreal)
C Larochelle
Affiliation:
(Montreal)
N Arbour
Affiliation:
(Montreal)
C Stapf
Affiliation:
(Montreal)
LC Gioia
Affiliation:
(Montreal)
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Abstract

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Background: Glial fibrillary acidic protein (GFAP), a brain-specific biomarker, shows promise in differentiating intracerebral hemorrhage (ICH) from acute ischemic stroke (IS) and stroke mimics (SM). A novel point-of-care platform measures GFAP in minutes, yet requires centrifugation to obtain plasma. We aim to determine whether participants recruited in an ongoing prospective biomarker study (during working hours) differ from non-recruited patients. Methods: An exploratory analysis of undifferentiated stroke <24h from onset, where plasma GFAP levels (pg/ml) are measured (i-STAT Alinity) at hospital arrival. Clinical characteristics are compared among recruited and non-recruited patients. Results: Among the first 101 patients recruited, mean (±SD) age (70.8±14.5 years), % females (48%), and median (IQR) NIHSS (9(3-20) were similar to the 270 non-recruited patients (70.3±16.3 years, 51% females, NIHSS 7 (3-17), respectively) in the same time period. Median ASPECTS was slightly lower in recruited patients (10(9-10) vs (10(10-10)) (p=0.03). ICH and SM were more common among non-recruited (52% IS/13% ICH/32% SM) compared to recruited patients (67% IS/5% ICH/29% SM, p=0.002), while large-vessel occlusion was more common among those recruited (44% vs 19%, p=0.001). Conclusions: Clinical characteristics do not differ among recruited vs. non-recruited patients in an ongoing biomarker study, yet sampling bias exists regarding underlying stroke condition, with efforts to mitigate this going forward.

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Type
Abstracts
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation