• Xiang-Lin Chen, Bing-Jian Yu, and Mao-Hua Chen.
• The Second Zone, Department of Brain, The People's Hospital of Qingyuan, The Affiliated Qingyuan Hospital of Jinan University, B24 Xinchengyinquan Road, Qingcheng District, Qingyuan 511518, Guangdong Province, China.
• Peptides. 2014 Jun 1; 56: 111-5.

AbstractHigh plasma proenkephalin A level has been associated with ischemic stroke severity and clinical outcomes. This study aimed to assess the relationship between proenkephalin A and disease severity as well as to investigate its ability to predict long-term clinical outcome in patients with aneurysmal subarachnoid hemorrhage. Plasma proenkephalin A concentrations of one hundred and eighty patients and 180 sex- and age-matched healthy controls were measured by chemoluminescence sandwich immunoassay. Plasma proenkephalin A level was substantially higher in patients than in healthy controls (205.5±41.6 pmol/L vs. 90.8±21.1 pmol/L, P<0.001), was highly associated with World Federation of Neurological Surgeons (WFNS) score (r=0.470, P<0.001) and Fisher score (r=0.488, P<0.001), was an independent predictor for 6-month mortality [odds ratio (OR), 1.183; 95% confidence interval (CI), 1.067-1.339; P=0.004] and unfavorable outcome (Glasgow Outcome Scale score of 1-3) (OR, 1.119; 95% CI, 1.046-1.332; P=0.005) using multivariate analysis, and had high area under receiver operating characteristic curve (AUC) for prediction of 6-month mortality (AUC, 0.831; 95% CI, 0.768-0.883) and unfavorable outcome (AUC, 0.821; 95% CI, 0.757-0.874). The predictive value of the plasma proenkephalin A concentration was also similar to those of WFNS score and Fisher score (both P>0.05). In a combined logistic-regression model, proenkephalin A improved the AUCs of WFNS score and Fisher score, but the differences were not significant (both P>0.05). Thus, proenkephalin A level may be a useful, complementary tool to predict mortality and functional outcome at 6 months after aneurysmal subarachnoid hemorrhage.Copyright © 2014 Elsevier Inc. All rights reserved.

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