Early Serum Calprotectin (S100A8/A9) Predicts Delayed Cerebral Ischemia and Outcomes after Aneurysmal Subarachnoid Hemorrhage |
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| Institution: | 2. Special Medicine Departments, General Hospital of Northern Theater Command, Shenyang, Liaoning, China;2. Departments of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan;2. University Hospital in Krakow, Poland;3. Jagiellonian University Medical College, Department of Radiology, Krakow, Poland;4. Jagiellonian University Medical College, Department of Pharmacology, Krakow, Poland;5. John Paul II Hospital, Krakow, Poland;6. Faculty of Medicine, University of Rzeszow, Poland;2. Faculty of Medicine, McGill University, Montreal, Quebec, Canada;3. Department of Medicine (Neurology), Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada;2. Department of Neurosurgery, Saga-ken Medical Centre Koseikan, Saga, Japan;2. Neurology Department, Royal Group of Hospitals, Belfast, Northern Ireland, United Kingdom;3. Stroke Unit, Altnagelvin Hospital, Derry, Northern Ireland, United Kingdom |
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| Abstract: | ObjectiveTo investigate the association of early serum calprotectin (S100A8/A9) level with disease severity and prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH).Patients and MethodsSerum samples were collected from 54 patients with aSAH (within 48 hours of onset) and 54 health controls. Levels of serum calprotectin were determined by enzyme linked immunosorbent assay. The clinical data of aSAH patients were collected. The prognosis was evaluated by modified Rankin scale at 3 months. Univariate and multivariable logistic regression analysis, bivariate correlation analysis and receiver operating characteristic (ROC) curve analysis were used respectively.ResultsSerum calprotectin levels were significantly higher in aSAH patients than that in healthy controls (P < .001). The clinical severity was also significantly correlated with the level of serum calprotectin. Patients with poor prognosis at 3 months showed higher serum calprotectin levels within 48 hours of onset than that in patients with good prognosis (P = .002). The level of serum calprotectin within 48 hours was related to the complications of secondary pneumonia. Serum calprotectin can be used as an independent predictor for delayed cerebral ischemia (DCI) after aSAH and poor prognosis in patients with aSAH at 3 months. The ROC curve showed the cutoff value of calprotectin for predicting poor prognosis at 3 months was 6020 pg/ml (sensitivity: 53.57%, specificity: 96.15%), and the cutoff value for predicting DCI was 5275 pg/ml (sensitivity: 68.42%, specificity: 82.86%).ConclusionSerum calprotectin concentrations within 48 hours after onset was significantly correlated with the clinical severity and the poor prognosis at 3 months in aSAH patients, suggesting that serum calprotectin may be a biomarker for early prediction of prognosis and complications in patients with aSAH and calprotectin may be a target for the treatment of aSAH. |
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