Can admission lipoprotein-associated phospholipase A2 predict the symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage?

Abstract

Background: Inflammation has been believed to be related to the development of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH). A potential biomarker for vascular inflammation that is well recognized is the lipoprotein-associated phospholipase A2 (Lp-PLA2). However, whether Lp-PLA2 can predict the occurrence of symptomatic cerebral vasospasm (SCV) in aSAH patients is still unknown. Thus, this study aimed to assess the value of Lp-PLA2 for predicting SCV in patients with aSAH. Methods: Between March 2017 and April 2018, we evaluated 128 consecutive aSAH patients who were admitted in the First Affiliated Hospital of Fujian Medical University. Their Lp-PLA2 level was obtained within 24 h of the initial bleeding. Factors might be related to SCV were analyzed. Results: Compared to patients without SCV, those with SCV (9.4%, 12/128) had significantly higher Lp-PLA2 level. Multivariate logistic analysis revealed that worse modified Fisher grade (OR = 10.08, 95% CI = 2.04-49.86, P = 0.005) and higher Lp-PLA2 level (OR = 6.66, 95% CI = 1.33-3.30, P = 0.021) were significantly associated with SCV, even after adjustment for confounders. Based on the best threshold, Lp-PLA2 had a sensitivity of 83.3% and a specificity of 51.7% for predicting SCV, as shown by the receiver operating characteristic curve analysis. In the poor World Federation of Neurosurgical Societies grade patient subgroup , patients with Lp-PLA2 > 200 μg/L had significantly higher SCV rate than that of patients having Lp-PLA2 ≤ 200 μg/L. Conclusion: The admission Lp-PLA2 level might be a helpful predictor for SCV in aSAH.

Biomarkers in aneurysmal subarachnoid hemorrhage: A short review

“… 55 Moreover, Lp-PLA2 obtained within the first 24 h post-aSAH predicted symptomatic cerebral vasospasm in patients with aSAH. 56 Similarly, the serum level of Lp-PLA2 was significantly elevated in patients with DCI and decreased within the first 2 days after admission. Thus, Lp-PLA2 in the early stages of aSAH might be a novel predictive biomarker for the occurrence of DCI.…”