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Auricchio AM, Baroni S, Rezai Jahromi B, Valz Gris A, Sturiale CL, Ceccarelli GM, Obersnel M, Menna G, Martinelli R, Napoli G, Scarcia L, Alexandre A, Caricato A, Di Bonaventura R, Albanese A, Marchese E, Covino M, Olivi A, Della Pepa GM. Predicting Role of GFAP and UCH-L1 biomarkers in Spontaneous Subarachnoid Hemorrhage: a preliminary study to evaluate in the short-term their correlation with severity of bleeding and prognosis. J Clin Neurosci 2024; 126:119-127. [PMID: 38870641 DOI: 10.1016/j.jocn.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Spontaneous non-traumatic subarachnoid hemorrhage (sSAH) is a severe brain vascular accident. Glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) can be theoretically assayed to predict a patient's progression, picturing different aspects of clinical failure after sSAH. The study aims to: a) explore the correlation between sSAH blood volume and biomarkers variation; b) evaluate if these can be predictive of the neurogenic response after sSAH and be prognostic of patient outcome; c) establish eventual threshold levels of biomarkers to define patients' clinical outcome. METHODS Blood volumetry at CT scan upon admission, GFAP and UCH-L1 were collected at 24 h, at 72 h, and after 7 days from hemorrhage. Trends and cut-off serum sampling were determined. Clinical outcome was assessed with mRS scale at 14 days. RESULTS A strong correlation between GFAP and UCH-L1 and blood diffusion volume in all explored serum intervals related to unfavorable outcome. GFAP and UCH-L1 were very early predictors of unfavorable outcomes at 24 h from sSAH (p = 0.002 and 0.011 respectively). Threshold levels of UCH-L1 apparently revealed a very early, early and late predictor of unfavorable outcomes. CONCLUSION GFAP and UCH-L1 represent a potential tool for prompt monitoring and customization of therapies in neurosurgical patients.
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Affiliation(s)
- Anna Maria Auricchio
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Silvia Baroni
- Department of Diagnostic and Laboratory Medicine, Unity of Chemistry, Biochemistry and Clinical Molecular Biology, Corelab, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Basic Biotechnological Sciences, Intensive Care and Perioperative Clinics Research, Catholic University of the Sacred Heart, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Behnam Rezai Jahromi
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Angelica Valz Gris
- Department of Life Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carmelo Lucio Sturiale
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Maria Ceccarelli
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Obersnel
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Grazia Menna
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Renata Martinelli
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Napoli
- Department of Diagnostic and Laboratory Medicine, Unity of Chemistry, Biochemistry and Clinical Molecular Biology, Corelab, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Scarcia
- Department of Diagnostic Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Alexandre
- Department of Diagnostic Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anselmo Caricato
- Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Rina Di Bonaventura
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessio Albanese
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Enrico Marchese
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marcello Covino
- Emergency Medicine Department, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Olivi
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Maria Della Pepa
- Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Misra S, Kawamura Y, Singh P, Sengupta S, Nath M, Rahman Z, Kumar P, Kumar A, Aggarwal P, Srivastava AK, Pandit AK, Mohania D, Prasad K, Mishra NK, Vibha D. Prognostic biomarkers of intracerebral hemorrhage identified using targeted proteomics and machine learning algorithms. PLoS One 2024; 19:e0296616. [PMID: 38829877 PMCID: PMC11146689 DOI: 10.1371/journal.pone.0296616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/16/2024] [Indexed: 06/05/2024] Open
Abstract
Early prognostication of patient outcomes in intracerebral hemorrhage (ICH) is critical for patient care. We aim to investigate protein biomarkers' role in prognosticating outcomes in ICH patients. We assessed 22 protein biomarkers using targeted proteomics in serum samples obtained from the ICH patient dataset (N = 150). We defined poor outcomes as modified Rankin scale score of 3-6. We incorporated clinical variables and protein biomarkers in regression models and random forest-based machine learning algorithms to predict poor outcomes and mortality. We report Odds Ratio (OR) or Hazard Ratio (HR) with 95% Confidence Interval (CI). We used five-fold cross-validation and bootstrapping for internal validation of prediction models. We included 149 patients for 90-day and 144 patients with ICH for 180-day outcome analyses. In multivariable logistic regression, UCH-L1 (adjusted OR 9.23; 95%CI 2.41-35.33), alpha-2-macroglobulin (aOR 5.57; 95%CI 1.26-24.59), and Serpin-A11 (aOR 9.33; 95%CI 1.09-79.94) were independent predictors of 90-day poor outcome; MMP-2 (aOR 6.32; 95%CI 1.82-21.90) was independent predictor of 180-day poor outcome. In multivariable Cox regression models, IGFBP-3 (aHR 2.08; 95%CI 1.24-3.48) predicted 90-day and MMP-9 (aOR 1.98; 95%CI 1.19-3.32) predicted 180-day mortality. Machine learning identified additional predictors, including haptoglobin for poor outcomes and UCH-L1, APO-C1, and MMP-2 for mortality prediction. Overall, random forest models outperformed regression models for predicting 180-day poor outcomes (AUC 0.89), and 90-day (AUC 0.81) and 180-day mortality (AUC 0.81). Serum biomarkers independently predicted short-term poor outcomes and mortality after ICH. Further research utilizing a multi-omics platform and temporal profiling is needed to explore additional biomarkers and refine predictive models for ICH prognosis.
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Affiliation(s)
- Shubham Misra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States of America
| | - Yuki Kawamura
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States of America
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Praveen Singh
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Shantanu Sengupta
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Manabesh Nath
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Zuhaibur Rahman
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Pradeep Kumar
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Kumar
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
- Department of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Praveen Aggarwal
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Achal K. Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh K. Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Dheeraj Mohania
- Department of Dr. RP Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Nishant K. Mishra
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States of America
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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3
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Kirby C, Barrington J, Sondag L, Loan JJ, Schreuder FH, McColl BW, Klijn CJ, Al-Shahi Salman R, Samarasekera N. Association between circulating inflammatory biomarkers and functional outcome or perihaematomal oedema after ICH: a systematic review & meta-analysis. Wellcome Open Res 2023; 8:239. [PMID: 38037559 PMCID: PMC10687391 DOI: 10.12688/wellcomeopenres.19187.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/02/2023] Open
Abstract
Background Currently, there are no specific medical treatments for intracerebral haemorrhage (ICH), but the inflammatory response may provide a potential route to treatment. Given the known effects of acute brain injury on peripheral immunity, we hypothesised that inflammatory biomarkers in peripheral blood may be associated with clinical outcome following ICH, as well as perihaematomal oedema (PHO), which is an imaging marker of the neuroinflammatory response. Methods We searched OVID Medline and EMBASE on 07 April 2021 for studies of humans with ICH measuring an inflammatory biomarker in peripheral blood and PHO or clinical outcome. Risk of bias was assessed both by using a scale comprising features of the Newcastle-Ottawa Assessment Scale, STROBE-ME and REMARK guidelines, and for studies included in meta-analysis, also by the QUIPS tool.We used random effects meta-analysis to pool standardised mean differences (SMD) if ≥1 study quantified the association between identical biomarkers and measures of PHO or functional outcome. Results Of 8,615 publications, 16 examined associations between 21 inflammatory biomarkers and PHO (n=1,299 participants), and 93 studies examined associations between ≥1 biomarker and clinical outcome (n=17,702 participants). Overall, 20 studies of nine biomarkers (n=3,199) met criteria for meta-analysis of associations between inflammatory biomarkers and clinical outcome. Death or dependency (modified Rankin Scale (mRS) 3‒6) 90 days after ICH was associated with higher levels of fibrinogen (SMD 0.32; 95%CI [0.04, 0.61]; p=0.025), and high mobility group box protein 1 (HMGB1) (SMD 1.67; 95%CI [0.05, 3.30]; p=0.04). Higher WBC was associated with death or dependency at 90 days (pooled SMD 0.27; 95% CI [0.11, 0.44]; p=0.001; but the association was no longer significant when the analysis was restricted to studies with a low risk of bias (pooled SMD 0.22; 95% CI -0.04-0.48). Higher CRP seemed to be associated with death or dependency at 90 days (pooled SMD 0.80; 95% CI [0.44, 1.17]; p<0.0001) but this association was no longer significant when adjusted OR were pooled (OR 0.99 (95% CI 0.98-1.01)). Conclusions Higher circulating levels of, fibrinogen and HMGB1 are associated with poorer outcomes after ICH. This study highlights the clinical importance of the inflammatory response to ICH and identifies additional research needs in determining if these associations are mediated via PHO and are potential therapeutic targets. Registration PROSPERO ( CRD42019132628; 28/05/2019).
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Affiliation(s)
- Caoimhe Kirby
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Jack Barrington
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Lotte Sondag
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - James J.M. Loan
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Floris H.B.M. Schreuder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Barry W. McColl
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Catharina J.M. Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Neshika Samarasekera
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
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4
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Nguyen AM, Saini V, Hinson HE. Blood-Based Biomarkers for Neuroprognostication in Acute Brain Injury. Semin Neurol 2023; 43:689-698. [PMID: 37751855 PMCID: PMC10668565 DOI: 10.1055/s-0043-1775764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Acute brain injury causes loss of functionality in patients that often is devastating. Predicting the degree of functional loss and overall prognosis requires a multifaceted approach to help patients, and more so their families, make important decisions regarding plans and goals of care. A variety of blood-based markers have been studied as one aspect of this determination. In this review, we discuss CNS-derived and systemic markers that have been studied for neuroprognostication purposes. We discuss the foundation of each protein, the conditions in which it has been studied, and how the literature has used these markers for interpretation. We also discuss challenges to using each marker in each section as well.
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Affiliation(s)
- Andrew M. Nguyen
- Neurosciences Critical Care Program, Department of Neurology, Oregon Health & Science University, Portland, Oregon
| | - Vishal Saini
- Neurosciences Critical Care Program, Department of Neurology, Oregon Health & Science University, Portland, Oregon
| | - H. E. Hinson
- Department of Neurology, University of California San Francisco, San Francisco, California
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5
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Karatzetzou S, Tsiptsios D, Sousanidou A, Fotiadou S, Christidi F, Kokkotis C, Gkantzios A, Stefas E, Vlotinou P, Kaltsatou A, Aggelousis N, Vadikolias K. Copeptin Implementation on Stroke Prognosis. Neurol Int 2023; 15:83-99. [PMID: 36648972 PMCID: PMC9844286 DOI: 10.3390/neurolint15010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/02/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Predicting functional outcome following stroke is considered to be of key importance in an attempt to optimize overall stroke care. Although clinical prognostic tools have been widely implemented, optimal blood biomarkers might be able to yield additional information regarding each stroke survivor's propensity for recovery. Copeptin seems to have interesting prognostic potential poststroke. The present review aims to explore the prognostic significance of copeptin in stroke patients. Literature research of two databases (MEDLINE and Scopus) was conducted to trace all relevant studies published between 16 February 2012 and 16 February 2022 that focused on the utility of copeptin as a prognostic marker in acute stroke setting. 25 studies have been identified and included in the present review. The predictive ability of copeptin regarding both functional outcome and mortality appears to be in the range of established clinical variables, thus highlighting the added value of copeptin evaluation in stroke management. Apart from acute ischemic stroke, the discriminatory accuracy of the biomarker was also demonstrated among patients with transient ischemic attack, intracerebral hemorrhage, and subarachnoid hemorrhage. Overall, copeptin represents a powerful prognostic tool, the clinical implementation of which is expected to significantly facilitate the individualized management of stroke patients.
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Affiliation(s)
- Stella Karatzetzou
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Dimitrios Tsiptsios
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Correspondence: ; Tel.: +30-6944320016
| | - Anastasia Sousanidou
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Styliani Fotiadou
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Foteini Christidi
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Christos Kokkotis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece
| | - Aimilios Gkantzios
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Eleftherios Stefas
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Pinelopi Vlotinou
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Antonia Kaltsatou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Nikolaos Aggelousis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece
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6
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Troiani Z, Ascanio L, Rossitto CP, Ali M, Mohammadi N, Majidi S, Mocco J, Kellner CP. Prognostic Utility of Serum Biomarkers in Intracerebral Hemorrhage: A Systematic Review. Neurorehabil Neural Repair 2021; 35:946-959. [PMID: 34541960 DOI: 10.1177/15459683211041314] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background. Intracerebral hemorrhage (ICH) accounts for 10-20% of all strokes and is associated with high morbidity and mortality. Recent studies have identified serum biomarkers as a means to improve outcome prognostication in poor grade ICH patients. Poor prognosis of ICH patients and complex pathophysiology of the disease necessitate prognostic serum biomarkers to help guide treatment recommendations. Objective. The objective is to systematically review all biomarkers used to predict long-term functional outcome in patients with spontaneous intracerebral hemorrhage. Results. We identified 36 studies investigating the predictive utility of 50 discrete biomarkers. Data from 4865 ICH patients were reviewed. Inflammatory biomarkers (11/50) were most often studied, followed by oxidative (8/50), then neuron and astrocyte-specific (7/50). S100 calcium binding protein B, white blood cell count, and copeptin were the most often studied individual biomarkers. The prognostic utility of 23 biomarkers was analyzed using receiver operating characteristic curves. Area under the curve (AUC) values for all available biomarkers except neutrophil/lymphocyte ratio were acceptable. Twenty of the 23 biomarkers were characterized by at least one excellent AUC value. Vascular endothelial growth factor, glial fibrillary astrocyte protein, and S100 calcium binding protein B were characterized by outstanding AUC. Conclusions. We identified the inflammatory and neuron and astrocyte-specific biomarker categories as having the greatest number of significant individual biomarker predictors of long-term outcome. Further investigation utilizing cross-validation of prediction models in a second independent group and blinded assessment of outcomes for the predictive utility of biomarkers in patients with ICH is warranted.
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Affiliation(s)
- Zachary Troiani
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Luis Ascanio
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Christina P Rossitto
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Muhammad Ali
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Nicki Mohammadi
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Shahram Majidi
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - J Mocco
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Christopher P Kellner
- Department of Neurosurgery, 5925Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
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Rübsamen N, Maceski A, Leppert D, Benkert P, Kuhle J, Wiendl H, Peters A, Karch A, Berger K. Serum neurofilament light and tau as prognostic markers for all-cause mortality in the elderly general population-an analysis from the MEMO study. BMC Med 2021; 19:38. [PMID: 33583409 PMCID: PMC7883435 DOI: 10.1186/s12916-021-01915-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neurofilament light chain (NfL) is a cytoskeletal protein component whose release into blood is indicative of neuronal damage. Tau is a microtubule-associated protein in neurons and strongly associated with overall brain degeneration. NfL and tau levels are associated with mortality in different neurological diseases, but studies in the general population are missing. We investigated whether NfL and tau serum levels could serve as prognostic markers for overall mortality in elderly individuals without pre-defined neurological conditions. Further, we investigated the cross-sectional associations between NfL, tau, neuropsychological functioning, and brain structures. METHODS In 1997, 385 inhabitants of Augsburg who were aged 65 years and older were included in the Memory and Morbidity in Augsburg Elderly (MEMO) study. They participated in a face-to-face medical interview including neuropsychological tests and magnetic resonance imaging (MRI) of the brain. NfL and tau were measured from non-fasting blood samples using highly sensitive single molecule array assays. To assess the prognostic accuracy of the biomarkers, concordance statistics based on the predicted 5-year survival probabilities were calculated for different Cox regression models. Associations between the biomarkers and the neuropsychological test scores or brain structures were investigated using linear or logistic regression. RESULTS NfL (HR 1.27, 95% CI [1.14-1.42]) and tau (1.20 [1.07-1.35]) serum levels were independently associated with all-cause mortality. NfL, but not tau, increased the prognostic accuracy when added to a model containing sociodemographic characteristics (concordance statistic 0.684 [0.612-0.755] vs. 0.663 [0.593-0.733]), but not when added to a model containing sociodemographic characteristics and brain atrophy or neuropsychological test scores. NfL serum levels were cross-sectionally associated with neuropsychological test scores and brain structures. CONCLUSIONS The association between NfL serum levels and brain atrophy and neuropsychological performance in individuals without overt neurological disease is similar to that seen in patients with neurodegenerative diseases. These findings support the concept of a continuum of physiological aging and incipient, subclinical pathology, and manifest disease. NfL, but not tau, serum levels might serve as a prognostic marker for all-cause mortality if no other clinical information is available.
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Affiliation(s)
- Nicole Rübsamen
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany.
| | - Aleksandra Maceski
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - David Leppert
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Pascal Benkert
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, University of Basel, Spitalstr 12, 4031, Basel, Switzerland
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Straße 33, 48149, Münster, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr 1, 85764, Neuherberg, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
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8
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Huangfu XQ, Wang LG, Le ZD, Tao B. Utility of serum amyloid A as a potential prognostic biomarker of acute primary basal ganglia hemorrhage. Clin Chim Acta 2020; 505:43-48. [PMID: 32088210 DOI: 10.1016/j.cca.2020.02.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Intracerebral hemorrhage (ICH) can lead to inflammation. Serum amyloid A (SAA) is an acute phase protein, which might be implicated in acute brain injury. We ascertain relationship between serum SAA and inflammation, severity plus outcome after ICH. METHODS In this prospective, observational study, serum SAA concentrations were quantified in 159 healthy volunteers and 159 acute primary basal ganglia hemorrhage patients admitted within 24 h after stroke symptom. Prognostic parameters included death and a poor outcome (modified Rankin Scale score > 2) at 90 days after stroke. RESULTS Serum SAA concentrations were substantially higher in patients than in controls. Among patients, serum SAA concentrations were strongly correlated with serum C-reactive protein concentrations, hematoma volume and National Institutes of Health Stroke Scale scores. Serum SAA appeared to be an independent predictor for 90-day death, overall survival and poor outcome. Under receiver operating characteristic curve, this protein exhibited similar prognostic capability, as compared to hematoma volume and National Institutes of Health Stroke Scale scores. CONCLUSIONS Rising serum SAA concentrations, in close correlation with inflammation and hemorrhagic severity, are independently related to mortality and poor outcome after ICH, indicating that serum SAA might serve as a potential prognostic biomarker for ICH.
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Affiliation(s)
- Xue-Qin Huangfu
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China.
| | - Lin-Guo Wang
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China
| | - Zhou-Di Le
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China
| | - Bo Tao
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China
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Prognostic value of copeptin in patients with aneurysmal subarachnoid hemorrhage. J Neuroimmunol 2019; 330:116-122. [PMID: 30875611 DOI: 10.1016/j.jneuroim.2019.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recently, copeptin has been identified as a plasma prognosis marker in acute ischemic stroke and intracerebral hemorrhage (ICH). This study investigated the prognostic value of copeptin in the patients with aneurysmal subarachnoid hemorrhage(aSAH). METHODS In this retrospective study, 243 consecutive patients were included. Upon admission, plasma copeptin levels were measured by enzyme-linked immunosorbent assay. The end points were mortality and poor functional outcome (Glasgow Outcome Scale score of 1-3) after 3 months. RESULTS In 243 patients, 112 (46.1%) were male and median age was 58 years (IQR 49-68). Median copeptin plasma levels were 21.0 pmol/l (IQR 13.2-31.2). Copeptin levels increased with increasing severity of aSAH as defined by the World Federation of Neurological Surgeons (WFNS) score. Patients with a poor outcome and nonsurvivors had significantly increased copeptin levels on admission (P < .001 both). In the multivariate analysis, for each 1 pmol/l increase of plasma concentration of copeptin, the adjusted risk of poor outcomes and mortality would be increased by and 6% (1.06 [1.02-1.10], P < .001) and 9% (1.09 [1.03-1.13], P < .001), respectively. Receiver operating characteristics to predict functional outcome and mortality demonstrated areas under the curve of copeptin of 0.74 (95% confidence interval [CI], 0.67-0.81) and 0.81 (95% CI, 0.74-0.87), which was comparable with the WFNS score(P > .05) but superior to C-reactive protein and IL-6 (P < .01). CONCLUSIONS The data shows that copeptin levels may reliably predict short-term prognosis at its onset in aSAH patients.
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Cai H, Zheng S, Cai B, Yao P, Ding C, Chen F, Kang D. Neuroglobin as a Novel Biomarker for Predicting Poor Outcomes in Aneurysmal Subarachnoid Hemorrhage. World Neurosurg 2018; 116:e258-e265. [PMID: 29738858 DOI: 10.1016/j.wneu.2018.04.184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Neuroglobin (Ngb) has a high affinity for oxygen and helps prevent hypoxic-ischemic brain damage. In this study we analyzed the relationship between Ngb levels and clinical outcomes of aneurysmal subarachnoid hemorrhage (aSAH). METHODS Serum Ngb levels were measured in 58 patients with aSAH and 27 control individuals using the enzyme-linked immunosorbent assay. To continuously assess aSAH, we measured serum Ngb levels on days 1, 2, 3, 5, and 7 after aSAH. Clinical data were collected using the Hunt and Hess Scale, the Glasgow Coma Scale (GCS), the World Federation of Neurological Surgeons (WFNS) Scale, and the modified Fisher Scale. Clinical outcomes included 6-month mortality and 6-month unfavorable outcomes (modified Rankin Scale (mRS) score of 3-6). RESULTS Serum Ngb levels increased after aSAH, peaked on day 2, and then gradually decreased. Serum Ngb levels on admission were higher in the patient group than in the control group (7.67 ± 2.56 ng/mL vs. 6.45 ± 0.88 ng/mL, P < 0.05). Multivariate logistic regression analysis indicated that serum Ngb levels on day 2 after aSAH were independently related to 6-month mortality (odds ratio [OR] = 0.265, 95% confidence interval [CI] = 0.094-0.747, P < 0.05) and 6-month unfavorable outcomes (OR = 1.919, 95% CI = 1.158-3.180, P < 0.05), and receiver operating characteristic curve analysis showed that serum Ngb levels on day 2 predicted 6-month mortality and 6-month unfavorable outcomes, with areas under the curve of 0.893 (P < 0.05; 95% CI, 0.812-0.974) and 0.818 (P < 0.05; 95% CI, 0.691-0.954), respectively, based on the best thresholds. CONCLUSIONS Serum Ngb levels on day 2 after aSAH were strongly associated with poor outcomes in aSAH, suggesting that Ngb may be a novel biomarker for predicting poor outcomes in aSAH.
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Affiliation(s)
- Hanpei Cai
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Shufa Zheng
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Bin Cai
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Peisen Yao
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Chenyu Ding
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Fuxiang Chen
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Dezhi Kang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
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Feng MJ, Ning WB, Wang W, Lv ZH, Liu XB, Zhu Y, Gao W, Jin HZ, Gao SS. Serum S100A12 as a prognostic biomarker of severe traumatic brain injury. Clin Chim Acta 2018; 480:84-91. [DOI: 10.1016/j.cca.2018.01.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 01/24/2018] [Accepted: 01/24/2018] [Indexed: 02/06/2023]
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12
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Wang LG, Huangfu XQ, Tao B, Zhong GJ, Le ZD. Serum tenascin-C predicts severity and outcome of acute intracerebral hemorrhage. Clin Chim Acta 2018; 481:69-74. [PMID: 29499198 DOI: 10.1016/j.cca.2018.02.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/22/2018] [Accepted: 02/25/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Tenascin-C is a matricellular protein related to brain injury. We studied serum tenascin-C in acute intracerebral hemorrhage (ICH) and examined the associations with severity and outcome following the acute event. METHODS Tenascin-C samples were obtained from 162 patients with acute hemorrhagic stroke and 162 healthy controls. Poor 90-day functional outcome was defined as modified Rankin Scale score > 2. Early neurological deterioration (END) and hematoma growth (HG) were recorded at 24 h. RESULTS Patients had higher tenascin-C levels than controls. Tenascin-C levels were positively correlated with hematoma volume or National Institutes of Health Stroke Scale score at baseline. Elevated tenascin-C levels were independently associated with END, HG, 90-day mortality and poor functional outcome. Moreover, tenascin-C levels significantly predicted END, HG and 90-day outcomes under receiver operating characteristic curves. CONCLUSIONS An increase in serum tenascin-C level is associated with an adverse outcome in ICH patients, supporting the potential role of serum tenascin-C as a prognostic biomarker for hemorrhagic stroke.
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Affiliation(s)
- Lin-Guo Wang
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China.
| | - Xue-Qin Huangfu
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China
| | - Bo Tao
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China
| | - Guan-Jin Zhong
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China
| | - Zhou-Di Le
- Department of Neurosurgery, The First People's Hospital of Tonglu County, 338 Xuesheng Road, Tonglu 311500, China
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Zheng YK, Dong XQ, Du Q, Wang H, Yang DB, Zhu Q, Che ZH, Shen YF, Jiang L, Hu W, Wang KY, Yu WH. Comparison of plasma copeptin and multiple biomarkers for assessing prognosis of patients with aneurysmal subarachnoid hemorrhage. Clin Chim Acta 2017; 475:64-69. [PMID: 29037840 DOI: 10.1016/j.cca.2017.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/07/2017] [Accepted: 10/12/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Increased plasma copeptin concentrations are related to poor prognosis after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to assess prognostic significance of plasma copeptin detection compared with glial fibrillary astrocyte protein, myelin basic protein, S100B, phosphorylated axonal neurofilament subunit H, neuron-specific enolase, tau and ubiquitin carboxyl-terminal hydrolase L1 in aSAH. METHODS We detected plasma concentrations of the aforementioned biomarkers in 105 healthy controls using ELISA. Their predictive ability for symptomatic cerebral vasospasm and 6-month poor outcome (Glasgow Outcome Scale score of 1-3) were compared. RESULTS Plasma concentrations of the preceding biomarkers were highly correlated with World Federation of Neurological Surgeons subarachnoid hemorrhage scale (WFNS) scores as well as were significantly higher in patients with symptomatic cerebral vasospasm than in those without symptomatic cerebral vasospasm and in patients with poor outcome than in those with good outcome. In terms of area under receiver operating characteristic curve, their predictive value for symptomatic cerebral vasospasm and 6-month poor outcome was in the range of WFNS scores. Plasma copeptin concentration, but not plasma concentrations of other biomarkers, statistically significantly improved the predictive performance of WFNS scores. CONCLUSIONS Copeptin in plasma might have the potential to be a useful prognostic biomarker for aSAH.
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Affiliation(s)
- Yong-Ke Zheng
- Department of Intensive Care Unit, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Xiao-Qiao Dong
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Quan Du
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Hao Wang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Ding-Bo Yang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Qiang Zhu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Zhi-Hao Che
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Yong-Feng Shen
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Li Jiang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Wei Hu
- Department of Intensive Care Unit, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Ke-Yi Wang
- Department of Central Laboratory, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China
| | - Wen-Hua Yu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China.
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Zhang R, Liu J, Zhang Y, Liu Q, Li T, Cheng L. Association Between Circulating Copeptin Level and Mortality Risk in Patients with Intracerebral Hemorrhage: a Systemic Review and Meta-Analysis. Mol Neurobiol 2017; 54:169-174. [PMID: 26732599 DOI: 10.1007/s12035-015-9626-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 12/08/2015] [Indexed: 10/25/2022]
Abstract
Copeptin has been identified as a biomarker of disease severity and is associated with mortality risk in several common diseases. This study sought to determine the association between circulating copeptin level and mortality risk in patients with intracerebral hemorrhage. PubMed, Web of Science, and Wanfang Medicine Database were searched for studies assessing the association between circulating copeptin level and mortality risk in patients with intracerebral hemorrhage. The pooled hazard ratio (HR) of mortality was calculated and presented with 95 % confidence interval (95 % CI). Data from 1332 intracerebral hemorrhage patients were derived from 9 studies. Meta-analysis showed that intracerebral hemorrhage patients with poor prognosis had much higher copeptin levels than those survivors (standardized mean difference = 1.68, 95 % CI 1.26-2.11, P < 0.00001). Meta-analysis of 8 studies with HRs showed that high circulating copeptin level was associated with higher risk of mortality in patients with intracerebral hemorrhage (HR = 2.42, 95 % CI 1.60-3.65, P < 0.0001). Meta-analysis of 6 studies with adjusted HRs showed that high circulating copeptin level was independently associated with higher risk of mortality in patients with intracerebral hemorrhage (HR = 1.67, 95 % CI 1.26-2.22, P = 0.0003). Our study suggests that there is an obvious association between circulating copeptin level and mortality in patients with intracerebral hemorrhage. High circulating copeptin level is independently associated with higher risk of mortality in patients with intracerebral hemorrhage.
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Affiliation(s)
- Ruoyu Zhang
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China.
| | - Jin Liu
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Ying Zhang
- Neuroscience Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Qiang Liu
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Tianlang Li
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Lei Cheng
- Department of Neurosurgery, The Affiliated Hospital of Shandong University, Jinan, 250019, China
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Chen QH, Lin D, Zhou J, Deng G. Role of signal peptide-Cub-Egf domain-containing protein-1 in serum as a predictive biomarker of outcome after severe traumatic brain injury. Clin Chim Acta 2016; 456:63-66. [DOI: 10.1016/j.cca.2016.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 02/17/2016] [Accepted: 02/26/2016] [Indexed: 11/24/2022]
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16
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Prognostic value of serum thioredoxin concentrations after intracerebral hemorrhage. Clin Chim Acta 2016; 455:15-9. [DOI: 10.1016/j.cca.2016.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 01/11/2016] [Accepted: 01/11/2016] [Indexed: 11/17/2022]
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17
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Lin XF, Ten XL, Tang XB, Chen J. Serum soluble CD40 ligand levels after acute intracerebral hemorrhage. Acta Neurol Scand 2016; 133:192-201. [PMID: 26032911 DOI: 10.1111/ane.12445] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Soluble CD40 ligand (sCD40L) is associated with inflammation. This study aimed to assess the prognostic value of sCD40L for clinical outcomes of acute intracerebral hemorrhage (ICH) patients. MATERIALS AND METHODS The serum sCD40L levels of 110 patients and 110 age- and gender-matched healthy controls were measured using sandwich immunoassays. The relationships between serum sCD40L levels and 1-week mortality, 6-month mortality, 6-month overall survival, 6-month unfavorable outcome (modified Rankin Scale score >2), and ICH severity including hematoma volume and National Institutes of Health Stroke Scale (NIHSS) score were assessed using multivariate analysis. RESULTS Compared with healthy controls, ICH patients had higher serum sCD40L levels. Serum sCD40L levels were correlated positively with hematoma volumes and NIHSS scores using a multivariate linear regression. Multivariate analysis results indicated that sCD40L was identified an independent predictor of 1-week mortality, 6-month mortality, 6-month unfavorable outcome and 6-month overall survival. sCD40L also showed high predictive performances for 1-week mortality, 6-month mortality and 6-month unfavorable outcome based on receiver operating characteristic curve. CONCLUSIONS Elevated serum sCD40L levels are independently associated with ICH severity and clinical outcomes. And sCD40L has potential to be a good prognostic biomarker of ICH.
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Affiliation(s)
- X.-F. Lin
- Department of Neurosurgery; The Central Hospital of Jinhua City; Jinhua China
| | - X.-L. Ten
- Department of clinical laboratory; Jinhua People's Hospital; Jinhua China
| | - X.-B. Tang
- Department of Emergency Medicine; Jinhua People's Hospital; Jinhua China
| | - J. Chen
- Department of Neurology; Jinhua People's Hospital; Jinhua China
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Dai JX, Cai JY, Lin Q, Chen XD, Lu C, Sun J, Ba HJ. Thioredoxin as a marker for severity and prognosis of aneurysmal subarachnoid hemorrhage. J Neurol Sci 2016; 363:84-9. [PMID: 27000227 DOI: 10.1016/j.jns.2016.02.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/06/2016] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Circulating levels of thioredoxin (Trx), a potent anti-oxidant that modulates inflammation, cell growth and apoptosis, are increased in various critical care conditions. The purpose of this study was to establish the relationship between serum Trx levels and prognosis of aneurysmal subarachnoid hemorrhage (aSAH). METHODS An enzyme-linked immunosorbent assay measurement of Trx was performed in serum from 132 patients and 132 healthy volunteers. Clinical outcomes included 6-month mortality and unfavorable outcome (Glasgow outcome scale score of 1-3). RESULTS The serum Trx levels were significantly higher in patients than in controls (23.4±12.2 ng/mL vs.8.5±4.0 ng/mL, P<0.001) and had close relation to the World Federation of Neurological Surgeons (WFNS) scores (r=0.461, P<0.001) and modified Fisher scores (r=0.459, P<0.001). Trx was an independent predictor for 6-month mortality (Odds ratio, 1.386; 95% confidence interval, 1.015-2.161; P<0.001) and 6-month unfavorable outcome (Odds ratio, 1.297; 95% confidence interval, 1.012-2.002; P<0.001). Based on receiver operating characteristic curve, TRX had similar prognostic value compared with WFNS scores and modified Fisher scores and also significantly improved their prognostic value for 6-month unfavorable outcome, but not for 6-month mortality. CONCLUSIONS Elevated plasma Trx levels are correlated with the severity and poor prognosis, substantializing Trx as a potential prognostic predictive biomarker following aSAH.
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Affiliation(s)
- Jun-Xia Dai
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Jian-Yong Cai
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Qun Lin
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Xian-Dong Chen
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Chuan Lu
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Jun Sun
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Hua-Jun Ba
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
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Łukaszyk E, Małyszko J. Copeptin: Pathophysiology and potential clinical impact. Adv Med Sci 2015; 60:335-41. [PMID: 26233637 DOI: 10.1016/j.advms.2015.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/29/2015] [Accepted: 07/02/2015] [Indexed: 12/24/2022]
Abstract
Copeptin, a C-terminal part of the precursor pre-provasopressin is a novel biomarker of arginine-vasopressin (AVP) system. Measurements of AVP concentration are not used in clinical practice because of technical difficulties. Copeptin is synthesized in stoichiometric ratio with AVP, hence it reflects vasopressin concentration in human plasma and serum. This review outlines current research concerning the role of copeptin as a prognostic marker in different diseases and its potential clinical value.
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Gao JB, Tang WD, Wang HX, Xu Y. Predictive value of thrombospondin-1 for outcomes in patients with acute ischemic stroke. Clin Chim Acta 2015; 450:176-80. [PMID: 26296896 DOI: 10.1016/j.cca.2015.08.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 07/30/2015] [Accepted: 08/17/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Thrombospondin-1 is a potent regulator of angiogenesis. The expression of cerebral thrombospondin-1 is promoted in a rat model of intracerebral hemorrhage. The current study was designed to investigate the change of plasma thrombospondin-1 concentrations and assess the prognostic value of plasma thrombospondin-1 concentrations for long-term mortality and functional outcome of ischemic stroke patients. METHODS This study included 192 patients and 150 healthy controls. The plasma thrombospondin-1 concentrations were measured using enzyme-linked immunosorbent assay. An unfavorable outcome was defined as a modified Rankin Scale score >3. The relationships between plasma thrombospondin-1 concentrations and 6-month clinical outcomes were analyzed using multivariate analysis. RESULTS Compared with healthy controls, plasma thrombospondin-1 concentrations were statistically significantly elevated in patients. Using multivariate analysis, thrombospondin-1 emerged as an independent predictor for 6-month mortality, 6-month unfavorable outcome and 6-month overall survival. Plasma thrombospondin-1 concentrations possessed high predictive values under receiver operating characteristic curve. Their predictive values were similar to those of National Institutes of Health Stroke Scale scores. CONCLUSIONS Plasma thrombospondin-1 concentrations are elevated obviously and are highly associated with long-term outcome of ischemic stroke.
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Affiliation(s)
- Jian-Bo Gao
- Department of Emergency Medicine, Fuyang People's Hospital, 2-4 Guihua Road, Fuyang 311400, Zhejiang Province, China.
| | - Wei-Dong Tang
- Department of Critical Care Medicine, Fuyang People's Hospital, 2-4 Guihua Road, Fuyang 311400, Zhejiang Province, China
| | - Hong-Xiang Wang
- Department of Neurology, Fuyang People's Hospital, 2-4 Guihua Road, Fuyang 311400, Zhejiang Province, China
| | - Yan Xu
- Department of Neurology, Fuyang People's Hospital, 2-4 Guihua Road, Fuyang 311400, Zhejiang Province, China
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Li K, Jia J, Wang Z, Zhang S. Elevated Serum Levels of NSE and S-100β Correlate with Increased Risk of Acute Cerebral Infarction in Asian Populations. Med Sci Monit 2015; 21:1879-88. [PMID: 26124190 PMCID: PMC4492484 DOI: 10.12659/msm.893615] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND We investigated the clinical value of serum levels of neuron-specific enolase (NSE) and human soluble protein-100β (S-100β) in acute cerebral infarction (ACI) patients. MATERIAL AND METHODS A literature search of electronic databases identified relevant case-control studies that examined the correlations between NSE and S-100β serum levels, and ACI. The retrieved studies were screened based on our strict inclusion and exclusion criteria, and high-quality studies were subsequently selected for meta-analysis. STATA software (Version 12.0, Stata Corporation, College Station, TX, USA) was utilized for statistical analysis. RESULTS A total of 13 case-control studies, containing 911 ACI patients and 686 healthy controls, were enrolled in this meta-analysis. The results of the meta-analysis showed that serum levels of NSE and S-100β in ACI patients were significantly higher than the control group. Subgroup analysis based on ethnicity revealed that the serum levels of NSE and S-100β in ACI patients were significantly higher than the control group in Asian population. In Caucasian population, the serum levels of NSE in case group was significantly higher than the control group, but no significant differences in serum levels of S-100β were observed between ACI patients and the control group. CONCLUSIONS Based on our results, we conclude that serum levels of NSE and S-100β strongly correlate with ACI in Asian population, and may be important clinical markers for diagnosis and treatment of ACI.
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Affiliation(s)
- Ke Li
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
| | - Jianjun Jia
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
| | - ZhenFu Wang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
| | - ShanChun Zhang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
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Prognostic role of copeptin after stroke: A systematic review and meta-analysis of observational studies. Sci Rep 2015; 5:11665. [PMID: 26119473 PMCID: PMC4483773 DOI: 10.1038/srep11665] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 06/01/2015] [Indexed: 11/29/2022] Open
Abstract
Copeptin, the C-terminal part of provasopressin, has emerged as a novel prognostic marker after hemorrhagic or ischemic stroke. The aim of this study was to quantitatively assess the prognostic significance of plasma copeptin level on functional outcome and mortality in patients with acute stroke using a meta-analysis of the available evidence. Thirteen relevant studies from 2,746 patients were finally included in our study. An elevated plasma copeptin level was associated with an increased risk of unfavorable outcome and mortality after stroke (OR 1.77; 95% CI, 1.44–2.19 and OR 3.90; 95% CI 3.07–4.95, respectively). The result of the pooled measure on standardized mean difference (SMD) was that plasma copeptin levels were found to be significantly higher in patients who died compared to survivors (SMD 1.70; 95% CI, 1.36–2.03). A stratified analysis by study region showed significant differences in SMD of copeptin, and the heterogeneity among studies was significantly decreased. However, the positive association of copeptin with poor prognosis after stroke was consistent in each stratified analysis. The present meta-analysis suggests that early measurement of plasma copeptin could provide better prognostic information about functional outcome and mortality in patients with acute stroke.
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Copeptin testing in acute myocardial infarction: ready for routine use? DISEASE MARKERS 2015; 2015:614145. [PMID: 25960596 PMCID: PMC4415476 DOI: 10.1155/2015/614145] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 01/12/2015] [Indexed: 01/11/2023]
Abstract
Suspected acute myocardial infarction is one of the leading causes of admission to emergency departments. In the last decade, biomarkers revolutionized the management of patients with suspected acute coronary syndromes. Besides their pivotal assistance in timely diagnosis, biomarkers provide additional information for risk stratification. Cardiac troponins I and T are the most sensitive and specific markers of acute myocardial injury. Nonetheless, in order to overcome the remaining limitations of these markers, novel candidate biomarkers sensitive to early stage of disease are being extensively investigated. Among them, copeptin, a stable peptide derived from the precursor of vasopressin, emerged as a promising biomarker for the evaluation of suspected acute myocardial infarction. In this review, we summarize the currently available evidence for the usefulness of copeptin in the diagnosis and risk stratification of patients with suspected acute myocardial infarction in comparison with routine biomarkers.
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Abstract
CONTEXT There is a need to improve stroke care through the prompt identification of stroke patients at increased risk of an adverse outcome. OBJECTIVE To evaluate the prognostic value of copeptin in patients with stroke. METHODS We systematically searched PubMed and Embase for relevant studies. Poor outcome and mortality were analyzed. RESULTS Twelve studies, containing 2682 patients, were included. Pooled analysis showed that copeptin is an independent prognostic marker of poor outcome after acute stroke and there is a borderline effect of copeptin in predicting mortality after acute stroke. CONCLUSIONS Copeptin is an independent predictor of poor outcome and mortality for patients with acute stroke.
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Affiliation(s)
- Lidong Jiao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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26
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Bustamante A, Garcia-Berrocoso T, Llombart V, Simats A, Giralt D, Montaner J. Neuroendocrine hormones as prognostic biomarkers in the setting of acute stroke: overcoming the major hurdles. Expert Rev Neurother 2014; 14:1391-403. [PMID: 25418815 DOI: 10.1586/14737175.2014.977867] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stroke represents one of the major causes of disability and mortality worldwide and prediction of outcome represents a challenge for both clinicians and researchers. In the past years, many blood markers have been associated with stroke outcome but despite this evidence, no biomarker is routinely used in stroke management. In this review, we focus on markers of the neuroendocrine system, which represent potential candidates to be implemented in clinical practice. Moreover, we present a systematic review and literature-based meta-analysis for copeptin, a new biomarker of the hypothalamo-pituitary-adrenal axis that has shown additional predictive value over clinical information in a large prospective study. The meta-analysis of the included 7 studies, with more than 2000 patients, reinforced its association with poor outcome (pooled odds ratio: 2.474 [1.678-3.268]) and mortality (pooled OR: 2.569 [1.642-3.495]). We further review the current situation of the topic and next steps to implement these tools by clinicians.
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Affiliation(s)
- Alejandro Bustamante
- Neurovascular Research Laboratory, Vall d'Hebron Institut of Research, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron, 119-129, 08035 Barcelona, Spain
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27
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Zhang ZY, Zhang LX, Dong XQ, Yu WH, Du Q, Yang DB, Shen YF, Wang H, Zhu Q, Che ZH, Liu QJ, Jiang L, Du YF. Comparison of the performances of copeptin and multiple biomarkers in long-term prognosis of severe traumatic brain injury. Peptides 2014; 60:13-7. [PMID: 25076464 DOI: 10.1016/j.peptides.2014.07.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 07/18/2014] [Accepted: 07/18/2014] [Indexed: 01/17/2023]
Abstract
Enhanced blood levels of copeptin correlate with poor clinical outcomes after acute critical illness. This study aimed to compare the prognostic performances of plasma concentrations of copeptin and other biomarkers like myelin basic protein, glial fibrillary astrocyte protein, S100B, neuron-specific enolase, phosphorylated axonal neurofilament subunit H, Tau and ubiquitin carboxyl-terminal hydrolase L1 in severe traumatic brain injury. We recruited 102 healthy controls and 102 acute patients with severe traumatic brain injury. Plasma concentrations of these biomarkers were determined using enzyme-linked immunosorbent assay. Their prognostic predictive performances of 6-month mortality and unfavorable outcome (Glasgow Outcome Scale score of 1-3) were compared. Plasma concentrations of these biomarkers were statistically significantly higher in all patients than in healthy controls, in non-survivors than in survivors and in patients with unfavorable outcome than with favorable outcome. Areas under receiver operating characteristic curves of plasma concentrations of these biomarkers were similar to those of Glasgow Coma Scale score for prognostic prediction. Except plasma copeptin concentration, other biomarkers concentrations in plasma did not statistically significantly improve prognostic predictive value of Glasgow Coma Scale score. Copeptin levels may be a useful tool to predict long-term clinical outcomes after severe traumatic brain injury and have a potential to assist clinicians.
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Affiliation(s)
- Zu-Yong Zhang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Li-Xin Zhang
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
| | - Xiao-Qiao Dong
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
| | - Wen-Hua Yu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Quan Du
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Ding-Bo Yang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Yong-Feng Shen
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Hao Wang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Qiang Zhu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Zhi-Hao Che
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Qun-Jie Liu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Li Jiang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Yuan-Feng Du
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
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Dong S, Li CL, Liang WD, Chen MH, Bi YT, Li XW. Postoperative plasma copeptin levels independently predict delirium and cognitive dysfunction after coronary artery bypass graft surgery. Peptides 2014; 59:70-4. [PMID: 25073070 DOI: 10.1016/j.peptides.2014.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 06/29/2014] [Accepted: 06/30/2014] [Indexed: 01/09/2023]
Abstract
Copeptin can reflect individual's stress state and are correlated with poor outcome of critical illness. The occurrence of postoperative delirium (POD) and cognitive dysfunction (POCD) is associated with worse outcome after coronary artery bypass graft (CABG) surgery. The present study aimed to investigate the ability of postoperative plasma copeptin level to predict POD and POCD in patients undergoing CABG surgery. Postoperative plasma copeptin levels of 108 patients were measured by an enzyme-linked immunosorbent assay. It was demonstrated that plasma copeptin levels were substantially higher in patients with POD than without POD (1.8±0.6 ng/mL vs. 1.1±0.3 ng/mL; P<0.001) and in patients with POCD than without POCD (1.9±0.6 ng/mL vs. 1.1±0.4 ng/mL; P<0.001). Plasma copeptin level and age were identified as independent predictors for POD [odds ratio (OR), 67.386; 95% confidence interval (CI), 12.031-377.426; P<0.001 and OR, 1.202; 95% CI, 1.075-1.345; P=0.001] and POCD (OR, 28.814; 95% CI, 7.131-116.425; P<0.001 and OR, 1.151; 95% CI, 1.030-1.285; P=0.003) using a multivariate analysis. For prediction of POD, the area under receiver operating characteristic curve (AUC) of the copeptin concentration (AUC, 0.883; 95% CI, 0.807-0.937) was markedly higher than that of age (AUC, 0.746; 95% CI, 0.653-0.825; P=0.020). For prediction of POCD, the AUC of the copeptin concentration (AUC, 0.870; 95% CI, 0.792-0.927) was markedly higher than that of age (AUC, 0.735; 95% CI, 0.641-0.815; P=0.043). Thus, postoperative plasma copeptin level may be a useful, complementary tool to predict POD and POCD in patients undergoing CABG surgery.
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Affiliation(s)
- Sheng Dong
- Department of Cardiothoracic Surgery, Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang 157001, China
| | - Chun-Lai Li
- Department of Anaesthesiology, Clinical Medical School, Mudanjiang Medical College, Mudanjiang, Heilongjiang 157011, China
| | - Wan-Dong Liang
- College of Life Science, Zhejiang Provincial Key Laboratory of Medical Genetics, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Mao-Hua Chen
- Department of Neurosurgery, The Centre Hospital of Wenzhou, Wenzhou, Zhejiang 325000, China
| | - Yun-Tian Bi
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Xing-Wang Li
- Department of Anesthesiology, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China.
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Yang DB, Yu WH, Dong XQ, Du Q, Shen YF, Zhang ZY, Zhu Q, Che ZH, Liu QJ, Wang H, Jiang L, Du YF. Plasma copeptin level predicts acute traumatic coagulopathy and progressive hemorrhagic injury after traumatic brain injury. Peptides 2014; 58:26-9. [PMID: 24905622 DOI: 10.1016/j.peptides.2014.05.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 05/27/2014] [Accepted: 05/27/2014] [Indexed: 01/13/2023]
Abstract
Higher plasma copeptin levels correlate with poor clinical outcomes after traumatic brain injury. Nevertheless, their links with acute traumatic coagulopathy and progressive hemorrhagic injury are unknown. Therefore, we aimed to investigate the relationship between plasma copeptin levels, acute traumatic coagulopathy and progressive hemorrhagic injury in patients with severe traumatic brain injury. We prospectively studied 100 consecutive patients presenting within 6h from head trauma. Progressive hemorrhagic injury was present when the follow-up computerized tomography scan reported any increase in size or number of the hemorrhagic lesion, including newly developed ones. Acute traumatic coagulopathy was defined as an activated partial thromboplastic time greater than 40s and/or international normalized ratio greater than 1.2 and/or a platelet count less than 120×10(9)/L. We measured plasma copeptin levels on admission using an enzyme-linked immunosorbent assay in a blinded fashion. In multivariate logistic regression analysis, plasma copeptin level emerged as an independent predictor of progressive hemorrhagic injury and acute traumatic coagulopathy. Using receiver operating characteristic curves, we calculated areas under the curve for progressive hemorrhagic injury and acute traumatic coagulopathy. The predictive performance of copeptin was similar to that of Glasgow Coma Scale score. However, copeptin did not obviously improve the predictive value of Glasgow Coma Scale score. Thus, copeptin may help in the prediction of progressive hemorrhagic injury and acute traumatic coagulopathy after traumatic brain injury.
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Affiliation(s)
- Ding-Bo Yang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Wen-Hua Yu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Xiao-Qiao Dong
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China.
| | - Quan Du
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Yong-Feng Shen
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Zu-Yong Zhang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Qiang Zhu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Zhi-Hao Che
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Qun-Jie Liu
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Hao Wang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Li Jiang
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
| | - Yuan-Feng Du
- Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, 261 Huansha Road, Hangzhou 310006, China
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30
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Plasma 8-iso-Prostaglandin F2α concentrations and outcomes after acute intracerebral hemorrhage. Clin Chim Acta 2014; 437:141-6. [PMID: 25079083 DOI: 10.1016/j.cca.2014.07.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Higher plasma 8-iso-Prostaglandin F2α concentrations have been associated with poor outcome of severe traumatic brain injury. We further investigated the relationships between plasma 8-iso-Prostaglandin F2α concentrations and clinical outcomes in patients with acute intracerebral hemorrhage. METHODS Plasma 8-iso-Prostaglandin F2α concentrations of 128 consecutive patients and 128 sex- and gender-matched healthy subjects were measured by enzyme-linked immunosorbent assay. We assessed their relationships with disease severity and clinical outcomes including 1-week mortality, 6-month mortality and unfavorable outcome (modified Rankin Scale score>2). RESULTS Plasma 8-iso-Prostaglandin F2α concentrations were substantially higher in patients than in healthy controls. Plasma 8-iso-Prostaglandin F2α concentrations were positively associated with National Institutes of Health Stroke Scale (NIHSS) scores and hematoma volume using a multivariate linear regression. It emerged as an independent predictor for clinical outcomes of patients using a forward stepwise logistic regression. ROC curves identified the predictive values of plasma 8-iso-Prostaglandin F2α concentrations, and found its predictive value was similar to NIHSS scores and hematoma volumes. However, it just numerically added the predictive values of NIHSS score and hematoma volume. CONCLUSIONS Increased plasma 8-iso-Prostaglandin F2α concentrations are associated with disease severity and clinical outcome after acute intracerebral hemorrhage.
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