Neuroglobin As A Novel Biomarker For The Poor Outcome Of Aneurysmal Subarachnoid Hemorrhage

Objective: Neuroglobin(Ngb)has a high oxygen affinity,and plays an important role in the protection of hypoxic-ischemic brain damage.This study was designed to analyze the relationship between Ngb and the clinical outcome of aneurysmal subarachnoid hemorrhage(a SAH).Methods: Serum Ngb levels were determined in a total of 58 aSAH patients and 27 controls,which were measured using enzyme-linked immunosorbent assay.The study included the consecutive patients with the first-ever non-traumatic SAH,the clinical history of a SAH within the last 24 hours before admission,the intracranial aneurysms identified by computerized tomography(CT)angiography with or without digital subtraction angiography and undergoing clipping or coiling within the 48 hours after admission.In addition,the serum Ngb levels of a SAH patients were determined continuously at days 1,2,3,5 and 7 after a SAH.Clinical dataes included the Hunt & Hess Scale,Glasgow Coma Scale(GCS),World Federation of Neurological Surgeons(WFNS)scale and modified Fisher grade.Clinical outcomes included 6-month mortality and unfavorable outcome(Modified Rankin Scale of 3–6).Results: The serum Ngb levels were increased after a SAH,peaked at day 2,gradually decreased afterwards.The admission serum Ngb levels were significantly higher in patients as compared to controls(7.67 ± 2.56 ng/m L vs.6.45 ± 0.88 ng/m L,P < 0.05).Multivariate logistic analysis showed that serum Ngb levels at day 2 after a SAH were related independently to 6-month mortality(OR = 0.265,95% CI = 0.094-0.747,P < 0.05)and 6-month unfavorable outcome(OR = 1.919,95% CI = 1.158-3.180,P < 0.05).Receiver operating characteristic curve analysis showed that serum Ngb levels at day 2 predicted 6-month mortality and 6-month unfavorable outcome with the area under curves of 0.893(95% CI,0.812-0.974;P< 0.05)and 0.818(95% CI,0.691-0.954;P < 0.05)on the basis of the best threshold.Conclusions: The serum Ngb levels at day 2 after aSAH were highly associated with the poor outcome of a SAH,suggesting that Ngb might be a novel biomarker for predicting the poor outcome of a SAH.