Page 805

Karger_ESC London_2013

London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 805 868 Intracerebral/subarachnoid haemorrhage and venous diseases Intra- and Extracranial Atherosclerotic Disease in Acute Spontaneous Intracerebral Hemor-rhage S. Sato1, T. Uehara2, M. Hayakawa3, K. Nagatsuka4, K. Minematsu5, K. Toyoda6 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, JAPAN1, Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, JAPAN2, Department of Cerebrovascular Medicine, National Cerebral and Cardiovas-cular Center, Suita, JAPAN3, Department of Neurology, National Cerebral and Cardiovascular Cen-ter, Suita, Japan, Suita, JAPAN4, Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, JAPAN5, Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, JAPAN6 Background: There are few available evidences regarding intracranial atherosclerotic disease (ICAD) and extracranial atherosclerotic disease (ECAD) of patients with acute spontaneous intrace-rebral hemorrhage (ICH). The purpose of our study was to elucidate the prevalence and the factors that correlate with ICAD and ECAD in ICH patients. Methods: A total of 274 patients with acute spontaneous ICH were enrolled. ICAD and ECAD (moderate to severe stenosis or occlusion) were mainly assessed by intracranial magnetic resonance angiography and carotid duplex sonography, respectively. Results: Fifty-one patients (19%) had ICAD or ECAD; 32 had ICAD and 21 had ECAD. On multi-variable analyses, age (OR, 1.52; 95% CI, 1.06-2.28 for every 10 years), monocyte count (OR, 1.37; 95% CI, 1.02-1.87 for every 100 /mm3), hemoglobin A1c (OR, 2.25; 95% CI, 1.08-5.15 for every 1%), and levels of low-density lipoprotein cholesterol (OR, 1.23; 95% CI, 1.08-1.42 for every 10 mg/dL) were independently associated with ICAD. Age (OR, 2.20; 95% CI, 1.20-4.38 for 10 years) and dyslipidemia (OR, 3.95; 95% CI, 1.01-15.97) were independently associated with ECAD. Conclusion: ICAD and ECAD were detected in approximately one-fifths of patients with sponta-neous ICH. Age and dyslipidemia (or lipid profile) were associated both with ICAD and ECAD. Monocyte count and hemoglobin A1c were associated with ICAD. The present findings may have practical implication for selecting patients with ICH who should be examined for ICAD and ECAD. 869 Intracerebral/subarachnoid haemorrhage and venous diseases Adrenomedullin levels predict mortality in patients with subarachnoidal hemorrhage C. Soriano-Tárraga1, E. Cuadrado-Godia2, A. Ois3, E. Giralt-Steinhauer4, J. Jimenez-Conde5, E. Vivas6, T. Solá7, M. Gracia-Arnillas8, J. Roquer9 Neurovascular Research Group (NEUVAS). IMIM - Hospital del Mar, Barcelona, SPAIN1, Stroke Unit. Neurology Department. Neurovascular Research Group (NEUVAS). IMIM - Hospital del Mar, Barcelona, SPAIN2, Stroke Unit. Neurology Department. Neurovascular Research Group (NEUVAS). IMIM - Hospital del Mar, Barcelona, SPAIN3, Stroke Unit. Neurology Department. Neurovascular Research Group (NEUVAS). IMIM - Hospital del Mar, Barcelona, SPAIN4, Stroke Unit. Neurology Department. Neurovascular Research Group (NEUVAS). IMIM - Hospital del Mar, Barcelona, SPAIN5, Neurology Department. Neurovascular Research Group (NEUVAS). IMIM - Hospital del Mar, Barcelona, SPAIN6, Neurology Department. Neurovascular Research Group (NEUVAS). IMIM - Hospital del Mar, Barcelona, SPAIN7, Intensive Care Medicine Service, Hos-pital del Mar, Barcelona, SPAIN8, Neurology Department. Neurovascular Research Group (NEU-VAS). IMIM - Hospital del Mar, Barcelona, SPAIN9 Background: Adrenomedullin (ADM) is a multifunctional 52-amino acid peptide hormone originat-ed primarily in endothelial cells which expression increases in cellular stress. It might contribute to maintain circulatory homeostasis by promoting vasorelaxation, natriuresis and cardiac outputs and may be a protective factor for blood vessels by counteracting vascular damage. ADM is difficult to measure in plasma because it is rapidly cleared from the circulation. Recently, the more stable midregional fragment of pro-ADM (MR-proADM) has been identified. MR-proADM is a powerful predictor of adverse outcome in patients with acute myocardial infarction. Its usefulness in cerebro-vascular pathology has yet not been proved. The aim of our study was to describe MR-proADM levels in patients with severe subarachnoidal hemorrhage (SAH) and to analyze its capability to predict mortality. Methodology: Prospective cohort of 57 patients admitted to a tertiary Hospital in Barcelona with the diagnosis of SAH fisher III-IV from 2010 to 2012. The end point was 90-day mortality. MR-proADM levels were measured in EDTA plasma. The MR-proADM was detected using a novel au-tomated immunofluorescent assay (Thermo Scientific BRAHMS MR-proADM KRYPTOR Immu-noassay, Germany). The samples were analyzed in duplicate and in a single batch. Results: Mean age was 56 (SD: 16.8) years. 90-day mortality rate was 33.3% (n=19). Median MR-proADM was 0.68 nmol/l q1-q3 0.51-0.91 (mean 0.81, SD 0.47). MR-proADM levels were associ-ated to 90-day mortality in univariate analysis p=0.01; 0.61 nmol/l (0.48-0.73) vs. 0.85 nmol/l (0.66- 1.44). Mortality rate in each quartile was (q1=11.1%, q2=30.8%, q3=33.3% q4=64.3%;p=0.018). MR-proADM levels were independently associated with 90-day mortality in multivariate analysis adjusted by age, sex, and initial Glasgow score (OR 3.77, 95% IC: 1.51-9.40, p=0.004). Conclusions. MR-proADM levels might be helpful predictors of mortality in patients with severe SAH.


Karger_ESC London_2013
To see the actual publication please follow the link above