Prognostic Value of Plasma β-Amyloid Levels in Patients With Acute Intracerebral Hemorrhage

Abstract

Background and Purpose— It has been proposed that the deposition of the β-amyloid peptide (Aβ) in the brain parenchyma and brain blood vessels has deleterious effects. We tested the hypothesis that the levels of plasma Aβ are related to the outcome in patients with intracerebral hemorrhage. Methods— In a multicenter study, we prospectively included patients with spontaneous intracerebral hemorrhage within the first 24 hours after onset. At admission, we measured plasma Aβ40 and Aβ42 levels using ELISA techniques. Also, we recorded age, sex, vascular risk factors, National Institutes of Health Stroke Scale score, presence of intraventricular hemorrhage, localization, cause, and volume of the hematoma. We obtained the modified Rankin scale and defined a unfavorable outcome as modified Rankin scale >2 at 3 months. Bivariate and multivariate regression analyses were performed. Results— We studied 160 patients (mean age, 73.8±11.3 years; 59.4% of them were men). A favorable outcome was observed in 64 (40%) of the patients. In the bivariate analyses, unfavorable outcome was associated with high age, female sex, diabetes mellitus, presence of intraventricular hemorrhage, high blood glucose, high National Institutes of Health Stroke Scale score, high volume, and high plasma levels of Aβ42 and Aβ40. The multivariate analysis showed that increased age (odds ratio, 1.07; 95% confidence interval, 1.035–1.21; P <0.0001), high admission National Institutes of Health Stroke Scale score (odds ratio, 1.29, 95% confidence interval, 1.17–1.42; P <0.0001), presence of diabetes mellitus (odds ratio, 4.15; 95% confidence interval, 1.21–14.1; P =0.02), and Aβ42 levels >9.7 pg/mL (odds ratio, 4.11; 95% confidence interval, 1.65–10.1; P =0.02) were independently associated with an increased likelihood of an unfavorable outcome. Conclusions— High levels of plasma Aβ42 in patients with acute intracerebral hemorrhage are associated with a poor functional prognosis.

CSF and Plasma Amyloid-β Temporal Profiles and Relationships with Neurological Status and Mortality after Severe Traumatic Brain Injury

“…In addition, the prognostic value of Aβ42 levels was unrelated to age. Furthermore, these findings are in agreement with those of 2 recent studies demonstrating a diagnostic and prognostic value of the Aβ42 levels in patients with acute and chronic intracerebral hemorrhage that was independent of age 24 25 . Finally, in future studies it might be worthwhile to analyze the influence of other relevant clinical variables, such as polytrauma, renal function and APOE ε4 status, on plasma Aβ42 concentrations.…”

Brain Perivascular Macrophages Initiate the Neurovascular Dysfunction of Alzheimer Aβ Peptides

“…The effect could not be attributed to depletion of microglia, to non-specific alterations in vascular structure and reactivity resulting in vasoparalysis, or to reductions in brain Aβ in Tg2576 mice. Elevated levels of circulating Aβ have been implicated in vascular alterations in AD and other dementias 51–54 , and lead to cerebrovascular disturbances in animal models 49 . Therefore, we asked if PVM also contribute to the deleterious neurovascular effects of circulating Aβ.…”

Plasmalemmal VDAC-1 corroborated as amyloid Aß-receptor

“…However, my hope is that looking on Alzheimer pathogenesis in the context of induced cell death will stimulate the field, this the more as recent literature indicates that amyloid Aß may work this way in other places (Martí-Fàbregas et al, 2014 ; Kaffashian et al, 2015 ; Zetterberg, 2015 ).…”