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Neutrophils extracellular traps myeloperoxidase and elastase predict cerebral vasospasms after aneurysmal subarachnoid hemorrhage. | LitMetric

AI Article Synopsis

  • - Aneurysmal subarachnoid hemorrhage (aSAH) is a severe medical condition with significant complications, such as cerebral vasospasm (CVS) and delayed ischemia, even after treatment.
  • - This study analyzed serum levels of specific components (MPO, ELA, cH3) from neutrophil extracellular traps (NETs) in patients with aSAH to evaluate their predictive value for CVS.
  • - Results indicate that while MPO and ELA levels alone didn't distinguish between patients with and without CVS, when combined in a logistic model, they effectively predicted CVS with high accuracy, suggesting a potential for early intervention in aSAH management.

Article Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is a highly fatal and morbid disease. Despite successful coiling or clipping of a ruptured aneurysm, the patients suffer post-aSAH complications, including early brain injury, cerebral vasospasm (CVS), delayed cerebral ischemia (DCI), and systemic infections that mainly determine the clinical outcomes. Diagnostic biomarkers to predict accurately post-aSAH complications are needed. In this prospective exploratory study, we investigated the predictive value of neutrophil extracellular traps (NETs) components for CVS after aSAH. In the study, 62 patients with aSAH, 17 patients with unruptured cerebral aneurysms, and 12 healthy controls were included. The serum levels of myeloperoxidase (MPO), elastase (ELA), and citrullinated histone H3 (cH3) on day 1 and day 4 of hospital admission were measured with ELISA. Data were scaled using the Yeo-Johnson transformation. Values in two groups were compared using a -test and in multiple groups using ANOVA. Logistic regression was used to model the outcome probability, including CVS, as the function of ELISA values. Among the patients with aneurysms, those who suffered aSAH had significantly higher levels of MPO (113.9 ± 294.4 vs. 422.3 ± 319.0 ng/ml, p < 0.05), ELA (84.8 ± 221.0 vs. 199.2 ± 218.9 ng/ml, p < 0.05), and cH3 (0.0 ± 0.0 vs. 2.8 ± 1.5, ng/ml, p < 0.05) on day one after aSAH, suggesting the involvement of NETs components in pathophysiology of aSAH and the events following aSAH. Individually, MPO and ELA levels taken on day 1 after SAH did not differ between patients with CVS and patients without CVS. However, when taken together into a logistic model, they allowed for predicting CVS with high sensitivity (91 %) and specificity (79 %). MPO and ELA, along with other clinical parameters, can be used as early predictors of CVS in aSAH patients and can serve as guidance during treatment decisions in the management of aSAH.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625263PMC
http://dx.doi.org/10.1016/j.heliyon.2024.e40562DOI Listing

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