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Published in: BMC Neurology 1/2015

Open Access 01-12-2015 | Study protocol

Biomarkers to enhance accuracy and precision of prediction of short-term and long-term outcome after spontaneous intracerebral haemorrhage: a study protocol for a prospective cohort study

Authors: A. Kumar, P. Kumar, S. Misra, R. Sagar, P. Kathuria, D. Vibha, S. Vivekanandhan, A. Garg, B. Kaul, S. Raghvan, S. P. Gorthi, S. Dabla, C. S. Aggarwal, Kameshwar Prasad

Published in: BMC Neurology | Issue 1/2015

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Abstract

Background

Several studies reported prognostic value of biomarker in intracerebral hemorrhagic (ICH) but they are either preliminary observation or inadequately powered to analyse independent contribution of biomarkers over and above clinical and neuroimaging data.

Objective

To examine whether the biomarker can significantly add to the predictive accuracy of prognosis of ICH.

Method/design

In a multi-centric prospective cohort study, 1020 patients with ICH within 72 hours of onset are being recruited. After obtaining written informed consent from patients/proxy, venous blood sample (10 ml) is being collected and analysed for C-reactive protein (CRP) level, S100B, Glial fibrillary acidic protein (GFAP), Troponin, change in leukocyte count and Copeptin levels. The patients are telephonically followed using stroke scales (Barthel Index and modified Rankin Scale) at 3, 6, 12 months and 2 years after the recruitment.

Discussion

This protocol will aim at predicting the short term or long term prognosis with the use of clinical, neuroimaging and biomarkers in order to help clinician to stratify patients for early referral or intervention.
Literature
1.
go back to reference Agnihotri S, Czap A, Staff I, Fortunato G, McCullough LD. Peripheral leukocyte counts and outcomes after intracerebral hemorrhage. J Neuroinflammation. 2011;8:160.CrossRefPubMedPubMedCentral Agnihotri S, Czap A, Staff I, Fortunato G, McCullough LD. Peripheral leukocyte counts and outcomes after intracerebral hemorrhage. J Neuroinflammation. 2011;8:160.CrossRefPubMedPubMedCentral
2.
go back to reference Aronowski J, Zhao X. Molecular pathophysiology of cerebral hemorrhage: secondary brain injury. Stroke J Cereb Circ. 2011;42(6):1781–6.CrossRef Aronowski J, Zhao X. Molecular pathophysiology of cerebral hemorrhage: secondary brain injury. Stroke J Cereb Circ. 2011;42(6):1781–6.CrossRef
3.
go back to reference Baffoun N, Lakhdhar R, Baccar K, Djebari K, Kaddour C. Cardiac injury in traumatic subarachnoid hemorrhagea: prospective study in 35 patients. Tunis Médicale. 2011;89(2):184–7. Baffoun N, Lakhdhar R, Baccar K, Djebari K, Kaddour C. Cardiac injury in traumatic subarachnoid hemorrhagea: prospective study in 35 patients. Tunis Médicale. 2011;89(2):184–7.
4.
go back to reference Blaschke F, Bruemmer D, Yin F, Takata Y, Wang W, Fishbein MC, et al. C-reactive protein induces apoptosis in human coronary vascular smooth muscle cells. Circulation. 2004;110(5):579–87.CrossRefPubMed Blaschke F, Bruemmer D, Yin F, Takata Y, Wang W, Fishbein MC, et al. C-reactive protein induces apoptosis in human coronary vascular smooth muscle cells. Circulation. 2004;110(5):579–87.CrossRefPubMed
5.
go back to reference Blumenreich MS. The White Blood Cell and Differential Count. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations [Internet]. 3rd ed. Boston: Butterworths; 1990 [cited 2015 May 18]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK261/ Blumenreich MS. The White Blood Cell and Differential Count. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations [Internet]. 3rd ed. Boston: Butterworths; 1990 [cited 2015 May 18]. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK261/​
6.
go back to reference Delgado P, Alvarez Sabin J, Santamarina E, Molina CA, Quintana M, Rosell A, et al. Plasma S100B level after acute spontaneous intracerebral hemorrhage. Stroke J Cereb Circ. 2006;37(11):2837–9.CrossRef Delgado P, Alvarez Sabin J, Santamarina E, Molina CA, Quintana M, Rosell A, et al. Plasma S100B level after acute spontaneous intracerebral hemorrhage. Stroke J Cereb Circ. 2006;37(11):2837–9.CrossRef
7.
go back to reference Di Napoli M, Godoy DA, Campi V, del Valle M, Piñero G, Mirofsky M, et al. C-reactive protein level measurement improves mortality prediction when added to the spontaneous intracerebral hemorrhage score. Stroke J Cereb Circ. 2011;42(5):1230–6.CrossRef Di Napoli M, Godoy DA, Campi V, del Valle M, Piñero G, Mirofsky M, et al. C-reactive protein level measurement improves mortality prediction when added to the spontaneous intracerebral hemorrhage score. Stroke J Cereb Circ. 2011;42(5):1230–6.CrossRef
8.
go back to reference Diedler J, Sykora M, Hahn P, Rupp A, Rocco A, Herweh C, et al. C-reactive-protein levels associated with infection predict short- and long-term outcome after supratentorial intracerebral hemorrhage. Cerebrovasc Dis Basel Switz. 2009;27(3):272–9.CrossRef Diedler J, Sykora M, Hahn P, Rupp A, Rocco A, Herweh C, et al. C-reactive-protein levels associated with infection predict short- and long-term outcome after supratentorial intracerebral hemorrhage. Cerebrovasc Dis Basel Switz. 2009;27(3):272–9.CrossRef
9.
go back to reference Donato R. S100: a multigenic family of calcium-modulated proteins of the EF-hand type with intracellular and extracellular functional roles. Int J Biochem Cell Biol. 2001;33(7):637–68.CrossRefPubMed Donato R. S100: a multigenic family of calcium-modulated proteins of the EF-hand type with intracellular and extracellular functional roles. Int J Biochem Cell Biol. 2001;33(7):637–68.CrossRefPubMed
10.
go back to reference Dong X-Q, Huang M, Yu W-H, Zhang Z-Y, Zhu Q, Che Z-H, et al. Change in plasma copeptin level after acute spontaneous basal ganglia hemorrhage. Peptides. 2011;32(2):253–7.CrossRefPubMed Dong X-Q, Huang M, Yu W-H, Zhang Z-Y, Zhu Q, Che Z-H, et al. Change in plasma copeptin level after acute spontaneous basal ganglia hemorrhage. Peptides. 2011;32(2):253–7.CrossRefPubMed
11.
go back to reference Feigin VL, Lawes CMM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8(4):355–69.CrossRefPubMed Feigin VL, Lawes CMM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8(4):355–69.CrossRefPubMed
12.
go back to reference Foerch C, Curdt I, Yan B, Dvorak F, Hermans M, Berkefeld J, et al. Serum glial fibrillary acidic protein as a biomarker for intracerebral haemorrhage in patients with acute stroke. J Neurol Neurosurg Psychiatry. 2006;77(2):181–4.CrossRefPubMed Foerch C, Curdt I, Yan B, Dvorak F, Hermans M, Berkefeld J, et al. Serum glial fibrillary acidic protein as a biomarker for intracerebral haemorrhage in patients with acute stroke. J Neurol Neurosurg Psychiatry. 2006;77(2):181–4.CrossRefPubMed
13.
go back to reference Garrett MC, Komotar RJ, Starke RM, Doshi D, Otten ML, Connolly ES. Elevated troponin levels are predictive of mortality in surgical intracerebral hemorrhage patients. Neurocrit Care. 2010;12(2):199–203.CrossRefPubMed Garrett MC, Komotar RJ, Starke RM, Doshi D, Otten ML, Connolly ES. Elevated troponin levels are predictive of mortality in surgical intracerebral hemorrhage patients. Neurocrit Care. 2010;12(2):199–203.CrossRefPubMed
14.
go back to reference Giroud M, Gras P, Chadan N, Beuriat P, Milan C, Arveux P, et al. Cerebral haemorrhage in a French prospective population study. J Neurol Neurosurg Psychiatry. 1991;54(7):595–8.CrossRefPubMedPubMedCentral Giroud M, Gras P, Chadan N, Beuriat P, Milan C, Arveux P, et al. Cerebral haemorrhage in a French prospective population study. J Neurol Neurosurg Psychiatry. 1991;54(7):595–8.CrossRefPubMedPubMedCentral
15.
go back to reference Godoy-Torres DA, Piñeiro G. [Inflammatory response in spontaneous intracerebral haemorrhage]. Rev Neurol. 2005;40(8):492–7.PubMed Godoy-Torres DA, Piñeiro G. [Inflammatory response in spontaneous intracerebral haemorrhage]. Rev Neurol. 2005;40(8):492–7.PubMed
16.
go back to reference Harrell FE, Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996;15(4):361–87.CrossRefPubMed Harrell FE, Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996;15(4):361–87.CrossRefPubMed
17.
go back to reference Hays A, Diringer MN. Elevated troponin levels are associated with higher mortality following intracerebral hemorrhage. Neurology. 2006;66(9):1330–4.CrossRefPubMed Hays A, Diringer MN. Elevated troponin levels are associated with higher mortality following intracerebral hemorrhage. Neurology. 2006;66(9):1330–4.CrossRefPubMed
18.
go back to reference James ML, Blessing R, Phillips-Bute BG, Bennett E, Laskowitz DT. S100B and brain natriuretic peptide predict functional neurological outcome after intracerebral haemorrhage. Biomark Biochem Indic Expo Response Susceptibility Chem. 2009;14(6):388–94. James ML, Blessing R, Phillips-Bute BG, Bennett E, Laskowitz DT. S100B and brain natriuretic peptide predict functional neurological outcome after intracerebral haemorrhage. Biomark Biochem Indic Expo Response Susceptibility Chem. 2009;14(6):388–94.
19.
go back to reference Kaneda K, Fujita M, Yamashita S, Kaneko T, Kawamura Y, Izumi T, et al. Prognostic value of biochemical markers of brain damage and oxidative stress in post-surgical aneurysmal subarachnoid hemorrhage patients. Brain Res Bull. 2010;81(1):173–7.CrossRefPubMed Kaneda K, Fujita M, Yamashita S, Kaneko T, Kawamura Y, Izumi T, et al. Prognostic value of biochemical markers of brain damage and oxidative stress in post-surgical aneurysmal subarachnoid hemorrhage patients. Brain Res Bull. 2010;81(1):173–7.CrossRefPubMed
20.
go back to reference Liao C-W, Cho W-L, Kao T-C, Su K-E, Lin Y-H, Fan C-K. Blood–brain barrier impairment with enhanced SP, NK-1R, GFAP and claudin-5 expressions in experimental cerebral toxocariasis. Parasite Immunol. 2008;30(10):525–34.CrossRefPubMed Liao C-W, Cho W-L, Kao T-C, Su K-E, Lin Y-H, Fan C-K. Blood–brain barrier impairment with enhanced SP, NK-1R, GFAP and claudin-5 expressions in experimental cerebral toxocariasis. Parasite Immunol. 2008;30(10):525–34.CrossRefPubMed
21.
go back to reference Maramattom BV, Manno EM, Fulgham JR, Jaffe AS, Wijdicks EFM. Clinical importance of cardiac troponin release and cardiac abnormalities in patients with supratentorial cerebral hemorrhages. Mayo Clin Proc. 2006;81(2):192–6.CrossRefPubMed Maramattom BV, Manno EM, Fulgham JR, Jaffe AS, Wijdicks EFM. Clinical importance of cardiac troponin release and cardiac abnormalities in patients with supratentorial cerebral hemorrhages. Mayo Clin Proc. 2006;81(2):192–6.CrossRefPubMed
23.
go back to reference Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344(19):1450–60.CrossRefPubMed Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344(19):1450–60.CrossRefPubMed
24.
go back to reference Sangha N, Gonzales NR. Treatment targets in intracerebral hemorrhage. Neurother J Am Soc Exp Neurother. 2011;8(3):374–87.CrossRef Sangha N, Gonzales NR. Treatment targets in intracerebral hemorrhage. Neurother J Am Soc Exp Neurother. 2011;8(3):374–87.CrossRef
25.
go back to reference Zhang X, Lu X-M, Huang L-F, Ye H. Copeptin is associated with one-year mortality and functional outcome in patients with acute spontaneous basal ganglia hemorrhage. Peptides. 2012;33(2):336–41.CrossRefPubMed Zhang X, Lu X-M, Huang L-F, Ye H. Copeptin is associated with one-year mortality and functional outcome in patients with acute spontaneous basal ganglia hemorrhage. Peptides. 2012;33(2):336–41.CrossRefPubMed
26.
go back to reference Zweifel C, Katan M, Schuetz P, Siegemund M, Morgenthaler NG, Merlo A, et al. Copeptin is associated with mortality and outcome in patients with acute intracerebral hemorrhage. BMC Neurol. 2010;10:34.CrossRefPubMedPubMedCentral Zweifel C, Katan M, Schuetz P, Siegemund M, Morgenthaler NG, Merlo A, et al. Copeptin is associated with mortality and outcome in patients with acute intracerebral hemorrhage. BMC Neurol. 2010;10:34.CrossRefPubMedPubMedCentral
Metadata
Title
Biomarkers to enhance accuracy and precision of prediction of short-term and long-term outcome after spontaneous intracerebral haemorrhage: a study protocol for a prospective cohort study
Authors
A. Kumar
P. Kumar
S. Misra
R. Sagar
P. Kathuria
D. Vibha
S. Vivekanandhan
A. Garg
B. Kaul
S. Raghvan
S. P. Gorthi
S. Dabla
C. S. Aggarwal
Kameshwar Prasad
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-015-0384-3

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