Utility of serum NOX4 as a potential prognostic biomarker for aneurysmal subarachnoid hemorrhage

Background: Nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) plays an important role in the formation of oxidative stress in brain tissues. We intended to investigate relationship between serum NOX4 concentrations and severity, delayed cerebral ischemia (DCI) plus prognosis after aneurysmal subarachnoid hemorrhage (aSAH). Methods: Serum NOX4 concentrations were gauged in a total of 165 aSAH patients. The World Federation of Neurological Surgeons (WFNS) scale and modified Fisher grading scale were recorded for assessing hemorrhagic severity. Relations of serum NOX4 concentrations to DCI and 90-day poor outcome (Glasgow outcome scale score of 1-3) were determined using multivariate analysis. Results: Serum NOX4 concentrations were substantially higher in patients with 90-day poor outcome or DCI than in other remainders. Serum NOX4 concentrations of patients were intimately correlated with WFNS scores and modified Fisher scores. Serum NOX4 appeared as an independent predictor for DCI and 90-day poor outcome after aSAH. Under ROC curve analysis, serum NOX4 concentrations possessed significantly high predictive capability for DCI and 90-day poor outcome following hemorrhagic stroke. Conclusions: Serum NOX4 concentrations, in close correlation with hemorrhagic severity, were independently associated with DCI and poor clinical outcome after hemorrhagic stroke, substantializing serum NOX4 as a promising prognostic biomarker for aSAH.

Automated summary

This study found that serum NOX4 concentrations were closely related to the severity, delayed cerebral ischemia (DCI), and 90-day prognosis of aneurysmal subarachnoid hemorrhage (aSAH) patients. Serum NOX4 concentrations were significantly correlated with WFNS scores and modified Fisher scores, serving as independent predictors for DCI and poor outcomes. Moreover, serum NOX4 concentrations showed high predictive capability for DCI and poor outcomes following hemorrhagic stroke.