Increased Plasma Galectin-3 Preceding the Development of Delayed Cerebral Infarction and Eventual Poor Outcome in Non-Se
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ORIGINAL ARTICLE
Increased Plasma Galectin-3 Preceding the Development of Delayed Cerebral Infarction and Eventual Poor Outcome in Non-Severe Aneurysmal Subarachnoid Hemorrhage Hirofumi Nishikawa 1 & Yoshinari Nakatsuka 1 & Masato Shiba 1 & Fumihiro Kawakita 2 & Masashi Fujimoto 2 & Hidenori Suzuki 1 & pSEED group
Received: 7 February 2017 / Revised: 17 July 2017 / Accepted: 11 August 2017 / Published online: 22 August 2017 # Springer Science+Business Media, LLC 2017
Abstract A matricellular protein galectin-3 is involved in tissue injury and inflammation, but the role of galectin-3 remains unclear in aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to assess whether acute-stage galectin-3 levels were associated with the subsequent development of neurovascular events and outcome after SAH. This study included 83 consecutive patients diagnosed with aneurysmal SAH of resuscitated World Federation of Neurological Surgeons (WFNS) grades 1–3. Plasma galectin-3 levels were once measured on days 1–3 (the day after clipping or coiling). Fifteen patients had poor outcomes, which were associated with increasing age, female, pre-onset morbidity, worse WFNS grade, modified Fisher computed tomography scale, acute hydrocephalus, and higher galectin-3 levels compared with good outcomes. Multivariate analyses revealed that plasma galectin-3 was an independent determinant for poor outcome (odds ratio, 3.08; 95% confidence interval, 1.58–6.00; p = 0.001). Among post-SAH neurovascular events occurring on day 4 and thereafter, delayed cerebral ischemia and infarction, but not angiographic vasospasm and shunt-dependent hydrocephalus, showed significantly higher plasma galectin3 levels on days 1–3. The receiver operating characteristic curve indicated that plasma galectin-3 with a cutoff value of
The pSEED group members along with their affiliations listed in the Appendix. * Hirofumi Nishikawa [email protected]
1
Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
2
Department of Neurosurgery, Saiseikai Matsusaka General Hospital, Matsusaka, Japan
3.30 or 3.48 ng/ml predicted delayed cerebral infarction development or poor outcome (specificity, 62.5%, 70.6%; sensitivity, 90.9%, 73.3%, respectively). The findings suggest that plasma galectin-3 levels on days 1–3 would be a useful biomarker for predicting subsequent development of delayed cerebral infarction and eventual poor outcome and provide a new candidate, which may mediate between post-SAH early brain injury or inflammation and delayed cerebral infarction without vasospasm. Keywords Galectin-3 . Matricellular protein . Cerebral infarction . Subarachnoid hemorrhage
Introduction The outcome of aneurysmal subarachnoid hemorrhage (SAH) remains poor despite advances in the diagnosis and treatment [1]. Many prognostic factors have been reported including delayed cerebral ischemia (DCI), cerebral vasospasminduced infarction, and shunt-dependent hydrocephalus as potentially preventable or trea
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