PB0032 - Myeloperoxidase-DNA Serum Titers and Delayed Cerebral Ischemia in Patients With Aneurysmal Subarachnoid Hemorrhage

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

VS

Valérie Spalart

PhD Student
Center for Molecular and Vascular Biology - KU Leuven
Leuven, Vlaams-Brabant, Belgium
PH

Philipp Hendrix

Attending Physician
Department of Neurosurgery, Saarland University Medical Center, Homburg/Saar, Germany
Homburg, Saarland, Germany
JO

Joachim Oertel

Chief of Neurosurgery
Department of Neurosurgery, Saarland University Medical Center, Homburg/Saar, Germany
Homburg, Saarland, Germany
SH

Sina Hemmer

Physician
Department of Neurosurgery, Saarland University Medical Center, Homburg/Saar, Germany
Homburg, Saarland, Germany
JG

Jürgen Geisel

Associate Professor
Department of Clinical Chemistry and Laboratory Medicine, Saarland University Medical Center, Homburg/Saar, Germany
Homburg, Saarland, Germany
HS

Hauke Schneider

Attending Physician
Universitätsklinikum Augsburg
Augsburg, Bayern, Germany
KM

Kimberly Martinod

Assistant Professor
Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
Leuven, Vlaams-Brabant, Belgium

Presenting Author(s)

Jens Witsch, MD

Assistant Professor
Department of Neurology, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States

Background: Myeloperoxidase (MPO)-DNA complexes have been associated with arterial and venous thrombosis. A potential role in patients with aneurysmal subarachnoid hemorrhage (aSAH) is unknown.

Aims: Here, we sought to explore whether serum MPO-DNA-complexes are present in patients with aSAH, and whether levels of serum MPO-DNA complexes are associated with delayed cerebral ischemia (DCI).

Methods: We performed a post-hoc analysis of a prospective, blinded, observational single-center biomarker study that enrolled consecutive patients with spontaneous SAH between July 2018 and September 2020. Serum samples obtained on admission and on hospital day 4 were analyzed for concentrations of MPO-DNA complexes. The primary outcome was the occurrence of DCI defined as new infarction on brain CT-scan. The secondary outcome was clinical vasospasm, a composite of clinical and transcranial doppler parameters. We used Wilcoxon’s signed-rank-test to assess for differences between paired measures.

Results: Among 100 patients with spontaneous SAH, mean age 59 (SD+13) years, 55% women, 78 patients had an aneurysmal SAH and complete DCI information. Among these, 29 (37%) developed DCI. MPO-DNA complexes were detected in all serum samples. The median MPO-DNA level was 33 ng/ml (IQR, 18-43 ng/ml) on admission, and 22 ng/ml (IQR, 11-31 ng/ml) on day 4 (Mann-Whitney test: p=0.015). In the primary outcome analysis, we found a significant reduction in MPO-DNA levels from admission to day 4 in patients with DCI (paired test, p=0.036) but not in those without DCI (p=0.171). The secondary analysis showed a similar reduction in MPO-DNA levels between admission and day 4 in patients with (p=0.006), but not in those without clinical vasospasm (p=0.473).

Conclusion(s): MPO-DNA-complexes are detectable in peripheral serum samples of patients with aSAH. A pronounced reduction in MPO-DNA levels over the first days after aSAH might herald DCI. The potential of MPO-DNA levels to serve as a biomarker of DCI requires further exploration.