title: Prognostic value of plasma β-amyloid levels in patients with acute intracerebral hemorrhage.
abstract: OBJECTIVE
  It has been proposed that the deposition of the β-amyloid peptide (Aβ) in the brain parenchyma and brain blood vessels has deleterious effects. We tested the hypothesis that the levels of plasma Aβ are related to the outcome in patients with intracerebral hemorrhage.
  
  
  METHODS
  In a multicenter study, we prospectively included patients with spontaneous intracerebral hemorrhage within the first 24 hours after onset. At admission, we measured plasma Aβ40 and Aβ42 levels using ELISA techniques. Also, we recorded age, sex, vascular risk factors, National Institutes of Health Stroke Scale score, presence of intraventricular hemorrhage, localization, cause, and volume of the hematoma. We obtained the modified Rankin scale and defined a unfavorable outcome as modified Rankin scale >2 at 3 months. Bivariate and multivariate regression analyses were performed.
  
  
  RESULTS
  We studied 160 patients (mean age, 73.8±11.3 years; 59.4% of them were men). A favorable outcome was observed in 64 (40%) of the patients. In the bivariate analyses, unfavorable outcome was associated with high age, female sex, diabetes mellitus, presence of intraventricular hemorrhage, high blood glucose, high National Institutes of Health Stroke Scale score, high volume, and high plasma levels of Aβ42 and Aβ40. The multivariate analysis showed that increased age (odds ratio, 1.07; 95% confidence interval, 1.035-1.21; P<0.0001), high admission National Institutes of Health Stroke Scale score (odds ratio, 1.29, 95% confidence interval, 1.17-1.42; P<0.0001), presence of diabetes mellitus (odds ratio, 4.15; 95% confidence interval, 1.21-14.1; P=0.02), and Aβ42 levels >9.7 pg/mL (odds ratio, 4.11; 95% confidence interval, 1.65-10.1; P=0.02) were independently associated with an increased likelihood of an unfavorable outcome.
  
  
  CONCLUSIONS
  High levels of plasma Aβ42 in patients with acute intracerebral hemorrhage are associated with a poor functional prognosis.
authors.affiliation: From the Department of Neurology, IIB Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (J.M.-F., R.D.-M., R.M., D.C., L.D., C.G.-L., A.L.); Department of Neurology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain (N.P.d.l.O.); Department of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain (M.A.d.L.); Department of Neurology, Hospital General Universitario Santiago de Compostela, Santiago de Compostela, Spain (M.R.-Y.); Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain (J.S., F.P.); and Department of Neurology, Hospital Donostia, Donostia, Spain (A.M.D.A.).
authors.forename: Joan
authors.initials: J
authors.lastname: Martí-Fàbregas
authors.forename: Raquel
authors.initials: R
authors.lastname: Delgado-Mederos
authors.forename: Rebeca
authors.initials: R
authors.lastname: Marín
authors.forename: Natalia Pérez
authors.initials: NP
authors.lastname: de la Ossa
authors.forename: María
authors.initials: M
authors.lastname: Alonso de Leciñana
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Yáñez
authors.forename: Jordi
authors.initials: J
authors.lastname: Sanahuja
authors.forename: Francisco
authors.initials: F
authors.lastname: Purroy
authors.forename: Ana María
authors.initials: AM
authors.lastname: De Arce
authors.forename: David
authors.initials: D
authors.lastname: Carrera
authors.forename: Lavinia
authors.initials: L
authors.lastname: Dinia
authors.forename: Cristina
authors.initials: C
authors.lastname: Guardia-Laguarta
authors.forename: Alberto
authors.initials: A
authors.lastname: Lleó
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016229:Amyloid beta-Peptides / Q000097:blood*; D002543:Cerebral Hemorrhage / Q000097:blood*; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D048909:Diabetes Complications / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D016229:Amyloid beta-Peptides; D010446:Peptide Fragments; C078592:amyloid beta-protein (1-40); C075222:amyloid beta-protein (1-42)
keywords: amyloid; cerebral hemorrhage; prognosis