The relationship of α-hydroxybutyrate dehydrogenase with 1-year outcomes in patients with intracerebral hemorrhage: A retrospective study

Zhang Limin; Rasha Alsamani; Wu Jianwei; Shi Yijun; Wang Dan; Sun Yuehong; Liu Ziwei; Xu Huiwen; Wang Dongzhi; Zhao Xingquan; Zhang Guojun

doi:10.3389/fneur.2022.906249

The relationship of α-hydroxybutyrate dehydrogenase with 1-year outcomes in patients with intracerebral hemorrhage: A retrospective study

Front Neurol. 2022 Oct 18:13:906249. doi: 10.3389/fneur.2022.906249. eCollection 2022.

Authors

Zhang Limin^{1

2

3}, Rasha Alsamani^{1

2

3}, Wu Jianwei⁴, Shi Yijun^{1

2

3}, Wang Dan^{1

2

3}, Sun Yuehong^{1

2

3}, Liu Ziwei^{1

2

3}, Xu Huiwen^{1

2

3}, Wang Dongzhi^{1

2

3}, Zhao Xingquan⁴, Zhang Guojun^{1

2

3}

Affiliations

¹ Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China.
³ Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China.
⁴ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

Background and aims: Cardiac enzymes are recognized as a valuable tool for predicting the prognosis of various cardiovascular diseases. The prognostic value of alpha-hydroxybutyrate dehydrogenase (α-HBDH) in patients with intracerebral hemorrhage (ICH) was ambiguous and not evaluated.

Methods: Two hundred and thirteen Chinese patients with ICH participated in the study from December 2018 to December 2019. Laboratory routine tests and cardiac enzymes, including α-HBDH level, were examined and analyzed. All the patients were classified into two groups by the median value of α-HBDH: B1 <175.90 and B2 ≥175.90 U/L. The clinical outcomes included functional outcome (according to modified Rankin Scale (mRS) score ≥3), all-cause death, and recurrent cerebro-cardiovascular events 1 year after discharge. Associations between the α-HBDH and the outcomes were evaluated using logistic regression analysis. Univariate survival analysis was performed by the Kaplan-Meier method and log-rank test.

Results: Of the 213 patients, 117 had α-HBDH ≥175.90 U/L. Eighty-two patients had poor functional outcomes (mRS≥3). During the 1-year follow-up, a total of 20 patients died, and 15 of them had α-HBDH ≥175.90 U/L during the follow-up time. Moreover, 24 recurrent events were recorded. After adjusting confounding factors, α-HBDH (≥175.90) remained an indicator of poor outcome (mRS 3-6), all-cause death, and recurrent cerebro-cardiovascular events. The ORs for B2 vs. B1 were 4.78 (95% CI: 2.60 to 8.78, P = 0.001), 2.63 (95% CI: 0.80 to 8.59, P = 0.11), and 2.40 (95% CI: 0.82 to 7.02, P = 0.11) for poor functional outcomes with mRS ≥ 3, all-cause death, and recurrent cerebro-cardiovascular events, respectively.

Conclusion: Increased α-HBDH at admission was independently related to poor functional outcome and all-cause mortality in patients with ICH at 1-year follow-up.

Keywords: cardiovascular events; intracerebral hemorrhage; mortality; outcomes; α-HBDH.