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Abstract Details

Soluble ST2 Predicts Functional Outcome after Spontaneous Intracerebral Hemorrhage
Cerebrovascular Disease and Interventional Neurology
S15 - Intracerebral Hemorrhage and SAH (1:22 PM-1:33 PM)
003

sST2 is a member of the interleukin-1 receptor family known to predict outcome in cardiovascular disease and ischemic stroke. Its role in ICH has not been reported.

To determine if soluble ST2 (sST2) is associated with injury severity and functional outcome after intracerebral hemorrhage (ICH).

sST2 concentration was measured on plasma samples from prospectively collected cohorts totaling 69 patients who presented with ICH to Brigham and Women’s or Yale New Haven Hospitals. Blood samples were drawn at 24 ±12 hours after symptom onset. sST2 was measured using a commercially-available ELISA (Critical Diagnostics, San Diego, CA). Injury severity was determined by the admission Glasgow Coma Scale (GCS), with GCS ≤ 8 defined as severe injury. Outcome was assessed by modified Rankin Scale (mRS) at 90 days, with poor outcome defined as mRS 4-6. The association between sST2 and outcome was determined using logistic regression and receiver operating curve (ROC) analysis.

Patients with a more severe presentation (GCS ≤ 8) had a higher sST2 concentration (173.6ng/ml [IQR 91.1-259.1] vs. 41.5ng/ml IQR [25.4-94.2], p<0.0001). Higher sST2 was associated with poor outcome (OR 0.36, 95% CI 0.20-0.67, p = 0.001). ROC analysis demonstrated that sST2  >111.7ng/mL predicted poor outcome with a sensitivity of 58%, specificity of 81%, and area under the curve of 0.736.  Other predictors of outcome included GCS, hematoma volume, and ICH score. sST2 remained an independent predictor of mRS after adjustment for hematoma volume (adjusted OR 0.40, 95% CI 0.22-0.76, p = 0.005). sST2 was not independent of GCS or ICH score. 

Plasma sST2 is associated with initial GCS and functional outcome after intraparenchymal hemorrhage. These results support the role of sST2 as a candidate biomarker for hemorrhagic stroke and argue for further investigation of the ST2 pathway in the pathogenesis of neurologic injury.

Authors/Disclosures
Karen Li
PRESENTER
No disclosure on file
Matthew B. Bevers, MD, PhD (Brigham and Women's Hospital) Dr. Bevers has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for EBSCO. An immediate family member of Dr. Bevers has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Hinshaw Law. An immediate family member of Dr. Bevers has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Colorado Department of Law. An immediate family member of Dr. Bevers has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for US Attorney - State of Indiana. Dr. Bevers has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for McKnights International Law. Dr. Bevers has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Huff Powel Bailey. Dr. Bevers has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Adler Cohen. The institution of Dr. Bevers has received research support from NINDS. The institution of an immediate family member of Dr. Bevers has received research support from AHRQ. The institution of an immediate family member of Dr. Bevers has received research support from NIH/Kowa Industries. The institution of an immediate family member of Dr. Bevers has received research support from NIDA.
Zoe Wolcott, MD Ms. Wolcott has nothing to disclose.
No disclosure on file
Audrey Leasure Ms. Leasure has nothing to disclose.
Guido J. Falcone, MD (Yale School of Medicine) The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
Lauren H. Sansing, MD Dr. Sansing has nothing to disclose.
Kevin N. Sheth, MD, FAAN (Yale UniversityDivision of Neuro and Critical Care) Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.
W. T. Kimberly, MD, PhD (Massachusetts General Hospital) Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astrocyte Pharmaceuticals. Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acasti Pharma. Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hyperfine Inc.. Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurotherapeutics. Dr. Kimberly has stock in Woolsey Pharmaceuticals. Dr. Kimberly has stock in Acasti Pharma. The institution of Dr. Kimberly has received research support from Biogen. The institution of Dr. Kimberly has received research support from NControl Therapeutics. The institution of Dr. Kimberly has received research support from NIH. The institution of Dr. Kimberly has received research support from American Heart Association. The institution of Dr. Kimberly has received research support from Hyperfine, Inc.. Dr. Kimberly has received intellectual property interests from a discovery or technology relating to health care.