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sTWEAK is a marker of early haematoma growth and leukoaraiosis in intracerebral haemorrhage

Stroke & Vascular Neurology 2021年第4期6卷 528-535,I0011,I0012页

作者： Andrés da Silva-Candal Iria López-Dequidt Manuel Rodriguez-Yañez PauloÁvila-Gómez JoséManuel Pumar JoséCastillo Tomás Sobrino Francisco Campos Ramón Iglesias-Rey pablo hervella Clinical Neurosciences Research Laboratory(LINC) Health Research Institute of Santiago de Compostela(IDIS)Santiago de CompostelaSpain Department of Neurology Hospital Clínico UniversitarioSantiago de CompostelaSpain Department of Neuroradiology Hospital Clínico UniversitarioSantiago de CompostelaSpain

Objective To study the association between early growth of haematoma with biomarkers of endothelial dysfunction such as leukoaraiosis(LA)and the soluble tumour necrosis factor-like weak inducer of apoptosis(sTWEAK)in patients with intracerebral haemorrhage(ICH).Methods This is a retrospective observational study of patients with nontraumatic ICH.Clinical and biochemical parameters were analysed.sTWEAK levels were measured by ELISA.LA was analysed in the hemisphere without haemorrhage to avoid interference with the acute injury.The main endpoint was the haematoma growth evaluated by the difference in volume between the second and the initial neuroimage.Poor functional outcome,defined as a modified Rankin Scale>2 at 3 months,was considered as secondary endpoint.Receiver operating characteristic curve analysis was performed to stablish the best cut-off for sTWEAK levels associated with haematoma growth.Results We included 653 patients with ICH in our analysis(71.1±11.9 years,44%women).Haematoma growth was observed in 188 patients(28.8%).sTWEAK levels≥5600 pg/mL predicted ICH growth with a sensitivity of 84%and a specificity of 87%.sTWEAK levels≥5600 pg/mL and the presence of LA were associated with haematoma growth(OR:42.46;(CI 95%22.67 to 79.52)and OR:2.73(CI 95%1.39 to 5.34),respectively).Also,the presence of LA(OR:4.31(CI 95%2.89 to 6.42))and the interaction between ICH growth and sTWEAK(OR:2.23(CI 95%1.40 to 3.55))were associated with poor functional outcome at 3 months.Conclusion sTWEAKs,together with the presence and grade of LA,are biomarkers able to predict ICH growth and poor functional outcome in patients with ICH.

关键词： TWEAK intracerebral specificity

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