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The change of plasma pituitary adenylate cyclase‐activating polypeptide levels after aneurysmal subarachnoid hemorrhage
Author(s) -
Jiang L.,
Wang W.H.,
Dong X.Q.,
Yu W.H.,
Du Q.,
Yang D.B.,
Wang H.,
Shen Y.F.
Publication year - 2016
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12522
Subject(s) - medicine , subarachnoid hemorrhage , glasgow outcome scale , glasgow coma scale , confidence interval , odds ratio , hazard ratio , gastroenterology , logistic regression , receiver operating characteristic , area under the curve , endocrinology , surgery
Objective Elevated circulating pituitary adenylate cyclase‐activating polypeptide ( PACAP ) levels have been demonstrated to be associated with clinical outcomes of severe traumatic brain injury. The current study aimed to confirm whether elevated plasma PACAP levels are predictive of clinical outcomes of aneurysmal subarachnoid hemorrhage ( aSAH ). Materials and methods One hundred and eighteen aSAH patients and 118 controls were recruited. Plasma PACAP concentrations were determined using enzyme‐linked immunosorbent assay. Patients were followed up until death or completion of 6 months after aSAH . An unfavorable outcome was defined as Glasgow Outcome Scale score of 1–3. Results The admission PACAP levels were significantly elevated in all patients (296.6 ± 119.7 pg/ml) compared with controls (77.1 ± 17.9 pg/ml, P < 0.001). Plasma PACAP levels were independently associated with clinical severity indicated by World Federation of Neurological Surgeons (WFNS) score ( t = 4.745, P < 0.001) and Fisher score ( t = 4.239, P < 0.001) using a multivariate linear regression. PACAP was identified as an independent predictor for 6‐month mortality [odds ratio ( OR ), 1.014; 95% confidence interval ( CI ), 1.005–1.030; P < 0.001] and 6‐month unfavorable outcome ( OR , 1.012; 95% CI , 1.006–1.028; P < 0.001) and 6‐month overall survival (hazard ratio, 1.016; 95% CI , 1.008–1.023; P < 0.001) using a binary logistic regression analysis and a Cox's proportional hazard analysis, respectively. PACAP had similar predictive values compared with WFNS score and Fisher score according to the receiver operating characteristic curve analysis. Conclusions Higher plasma PACAP levels are associated with clinical severity and long‐term prognosis of aSAH patients, and PACAP has potential to be a good prognostic biomarker of aSAH .