Artikel
Prospective assessment of circulatory dipeptidyl peptidase 3 (cDPP3) as a potential biomarker after aneurysmal subarachnoid haemorrhage
Zikulatorische Dipeptidyl Peptidase 3 (cDPP3) als potentieller Biomarker nach aneurysmatischer Subarachnoidalblutung – eine prospektive Evaluation
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Autoren
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Felix Neumaier
- Universitätsklinikum Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
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Michael Veldeman
- Universitätsklinikum Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
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Miriam Weiss
- Universitätsklinikum Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
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Tim Phillip Simon
- Universitätsklinikum Aachen, Department of Intensive Care Medicine and Perioperative Care, Aachen, Deutschland
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Christian Stoppe
- Universitätsklinikum Aachen, Department of Intensive Care Medicine and Perioperative Care, Aachen, Deutschland
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Anke Höllig
- Universitätsklinikum Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
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Hans Clusmann
- Universitätsklinikum Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
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Gernot Marx
- Universitätsklinikum Aachen, Department of Intensive Care Medicine and Perioperative Care, Aachen, Deutschland
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Gerrit Alexander Schubert
- Universitätsklinikum Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
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Walid Albanna
- Universitätsklinikum Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
| Veröffentlicht: | 4. Juni 2021 |
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Gliederung
Text
Objective: Delayed cerebral ischemia (DCI) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH) that can culminate in infarction and secondary brain damage. Although DCI-related infarctions are one of the main preventable causes of SAH-related morbidity, there is still a lack of prognostic criteria for identification of patients at risk of developing DCI. Elevated circulatory levels of the cytosolic enzyme dipeptidyl peptidase 3 (DPP3) were recently identified as a promising potential biomarker for prediction of organ failure and outcome in critically ill patients. In the present study, we prospectively determined the temporal profile of circulatory DPP3 (cDPP3) levels in a cohort of aSAH patients and analyzed its relation to the development of DCI, DCI-related infarctions, and long-term outcome.
Methods: cDPP3 levels were quantified in serum samples obtained from 96 confirmed aSAH patients during the early (EP: d1-4), critical (CP: d5-8, d9-12, d13-15) and late (d16-21) phase after aSAH onset. Associations between cDPP3 levels and demographic or clinical parameters were evaluated. The relations between cDPP3 levels and DCI, DCI-related infarctions and long-term clinical outcomes were examined by receiver operating characteristics (ROC) curve analysis and multivariate logistic regression.
Results: Significantly higher cDPP3 levels during CP (d5-8, d9-12, d13-15) were observed in patients with poor clinical (p<0.001 to p=0.033) or radiological (p=0.012 to p=0.039) status on admission, DCI (p<0.001 to p=0.001), DCI-related infarctions (p=0.002 to p=0.007), and poorer long-term outcome (p=0.007 to p=0.019). ROC curve analysis showed that higher cDPP3 levels on day 5-8 after aSAH onset were predictive for unfavorable outcome (AUC=0.677, p=0.007). In multivariate analysis after adjusting for clinical severity upon admission, there was an independent association between cDPP3 levels on day 5-8 and development of DCI-related infarctions.
Conclusion: Our results provide first evidence that cDPP3 could be a promising biomarker for early diagnosis of DCI-related infarctions in poor grade aSAH patients. These findings and their clinical value should be validated and extended by additional human and animal studies.
