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. © 2019 Consilium Medikum. All rights reserved.