AUTHOR=Kiiski Heikki , Jalkanen Ville , Ala-Peijari Marika , Hämäläinen Mari , Moilanen Eeva , Peltola Jukka , Tenhunen Jyrki 

TITLE=Plasma Soluble Urokinase-Type Plasminogen Activator Receptor Is Not Associated with Neurological Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage

JOURNAL=Frontiers in Neurology

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00144

DOI=10.3389/fneur.2017.00144

ISSN=1664-2295

ABSTRACT=Abstract

Object Aneurysmal subarachnoid hemorrhage (aSAH) is a common cause of death or long-term disability. Despite advances in neurocritical care, there is still only a very limited ability to monitor the development of secondary brain injury or to predict neurological outcome after aSAH. Soluble urokinase-type Plasminogen Activator Receptor (suPAR) has shown potential as a prognostic and as an inflammatory biomarker in a wide range of critical illnesses since it displays an association with overall immune system activation. This is the first time that suPAR has been evaluated as a prognostic biomarker in aSAH. 

Methods In this prospective population-based study, plasma suPAR levels were measured in aSAH patients (n=47) for up to five days. SuPAR was measured at 0, 12 and 24 h after patient admission to the intensive care unit (ICU) and daily thereafter until he/she was transferred from the ICU. The patients’ neurological outcome was evaluated with the modified Rankin Scale (mRS) at six months after aSAH.

Results  SuPAR levels (n=47) during the first 24h after aSAH were comparable in groups with a favorable (mRS 0-2) or an unfavorable (mRS 3-6) outcome. SuPAR levels during the first 24 hours were not associated with the findings in the primary brain CT, with acute hydrocephalus or with antimicrobial medication use during five days’ follow-up. SuPAR levels were associated with generally accepted inflammatory biomarkers (CRP, leukocyte count). 

Conclusions Plasma suPAR level was not associated with either neurological outcome or selected clinical conditions. While suPAR is a promising biomarker for prognostication in several conditions requiring intensive care, it did not reveal any value as a prognostic biomarker after aSAH.