Molecular signatures of vascular injury are associated with early growth of intracerebral hemorrhage

  • Silva Y
  • Leira R
  • Tejada J
 et al. 
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BACKGROUND AND PURPOSE: To investigate whether molecular markers of inflammation and endothelial injury are associated with early growth of intracerebral hemorrhage (ICH). METHODS: In a multicenter prospective study, we determined concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), matrix metalloproteinase-9 (MMP-9), and cellular fibronectin (c-Fn) in blood samples obtained on admission from 183 patients with primary hemispheric ICH of 33% between the 2 CT examinations for ICH with a baseline volume 10% for ICH > or =20 mL. Clinical, radiological, and biochemical predictive factors of ICH enlargement were analyzed by logistic regression analysis. RESULTS: Fifty-four (29.5%) patients showed a relevant early growth of ICH. High leukocyte count and fibrinogen levels, low platelet count, and intraventricular bleeding were associated with early ICH growth in bivariate analyses. Plasma concentrations of IL-6 (median [quartiles]: 19.6 [13.6; 29.9] versus 15.9 [11.5; 19.8] pg/mL), TNF-alpha (13.5 [8.4; 30.5] versus 8.7 [4.7; 13.5] pg/mL), MMP-9 (153.3 [117.7; 204.7] versus 70.6 [47.8; 103.8] ng/mL), and c-Fn (8.8 [6.2; 12.5] versus 2.8 [1.6; 4.2] microg/mL) were significantly higher in patients with early growth of ICH (all P6 microg/mL (OR, 92; 95%CI, 22 to 381; P24 pg/mL (OR, 16; 95%CI, 2.3 to 119; P=0.005) were independently associated with ICH enlargement in the logistic regression analysis. CONCLUSIONS: Molecular signatures of vascular injury and inflammatory markers in the early acute phase of ICH are associated with subsequent enlargement of the hematoma.

Author-supplied keywords

  • Aged
  • Biological Markers/blood
  • Cerebral Hemorrhage/diagnosis/radiography
  • Cytokines/blood
  • Female
  • Fibronectins/blood
  • Hematoma/diagnosis
  • Humans
  • Interleukin-6/blood
  • Male
  • Matrix Metalloproteinase 9/blood
  • Prospective Studies
  • Tomography, X-Ray Computed
  • Tumor Necrosis Factor-alpha/analysis

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  • Y Silva

  • R Leira

  • J Tejada

  • J M Lainez

  • J Castillo

  • A Davalos

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