Utility of serum amyloid A as a potential prognostic biomarker of acute primary basal ganglia hemorrhage

• Published in: Clinica chimica acta 2020-06, Vol.505, p.43-48
• Main Authors: Huangfu, Xue-Qin, Wang, Lin-Guo, Le, Zhou-Di, Tao, Bo
• Format: Article
• Language: English
• Subjects: Aged; Basal Ganglia Hemorrhage - blood; Basal Ganglia Hemorrhage - complications; Biomarkers - blood; C-Reactive Protein - analysis; Female; Hematoma - pathology; Humans; Inflammation; Intracerebral hemorrhage; Male; Middle Aged; Mortality; Outcome; Prognosis; Prospective Studies; ROC Curve; Sensitivity and Specificity; Serum amyloid A; Serum Amyloid A Protein - analysis; Severity; Stroke - blood; Stroke - etiology; Survival Analysis; Treatment Outcome
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2020.02.022

•Serum amyloid A levels are elevated after intracerebral hemorrhagic.•Serum amyloid A levels are presumed for assessment of hemorrhagic severity.•Serum amyloid A might serve as a prognostic predictor for hemorrhagic stroke.•Serum amyloid A exhibit a good capability for predicting poor prognosis of intracerebral hemorrhage.•Serum amyloid A is intimately related to inflammation after intracerebral hemorrhage. Intracerebral hemorrhage (ICH) can lead to inflammation. Serum amyloid A (SAA) is an acute phase protein, which might be implicated in acute brain injury. We ascertain relationship between serum SAA and inflammation, severity plus outcome after ICH. In this prospective, observational study, serum SAA concentrations were quantified in 159 healthy volunteers and 159 acute primary basal ganglia hemorrhage patients admitted within 24 h after stroke symptom. Prognostic parameters included death and a poor outcome (modified Rankin Scale score > 2) at 90 days after stroke. Serum SAA concentrations were substantially higher in patients than in controls. Among patients, serum SAA concentrations were strongly correlated with serum C-reactive protein concentrations, hematoma volume and National Institutes of Health Stroke Scale scores. Serum SAA appeared to be an independent predictor for 90-day death, overall survival and poor outcome. Under receiver operating characteristic curve, this protein exhibited similar prognostic capability, as compared to hematoma volume and National Institutes of Health Stroke Scale scores. Rising serum SAA concentrations, in close correlation with inflammation and hemorrhagic severity, are independently related to mortality and poor outcome after ICH, indicating that serum SAA might serve as a potential prognostic biomarker for ICH.