Utility of serum amyloid A as a potential prognostic biomarker of acute primary basal ganglia hemorrhage

Abstract

Background: Intracerebral hemorrhage (ICH) can lead to inflammation. Serum amyloid A (SAA) is an acute phase protein, which might be implicated in acute brain injury. We ascertain relationship between serum SAA and inflammation, severity plus outcome after ICH.

Methods: In this prospective, observational study, serum SAA concentrations were quantified in 159 healthy volunteers and 159 acute primary basal ganglia hemorrhage patients admitted within 24 h after stroke symptom. Prognostic parameters included death and a poor outcome (modified Rankin Scale score > 2) at 90 days after stroke.

Results: Serum SAA concentrations were substantially higher in patients than in controls. Among patients, serum SAA concentrations were strongly correlated with serum C-reactive protein concentrations, hematoma volume and National Institutes of Health Stroke Scale scores. Serum SAA appeared to be an independent predictor for 90-day death, overall survival and poor outcome. Under receiver operating characteristic curve, this protein exhibited similar prognostic capability, as compared to hematoma volume and National Institutes of Health Stroke Scale scores.

Conclusions: Rising serum SAA concentrations, in close correlation with inflammation and hemorrhagic severity, are independently related to mortality and poor outcome after ICH, indicating that serum SAA might serve as a potential prognostic biomarker for ICH.

Keywords: Inflammation; Intracerebral hemorrhage; Mortality; Outcome; Serum amyloid A; Severity.