Plasma pituitary adenylate cyclase-activating polypeptide concentrations and mortality after acute spontaneous basal ganglia hemorrhage

Background: Plasma pituitary adenylate cyclase activating polypeptide (PACAP) concentrations are elevated after traumatic brain injury. We assessed the prognostic value of PACAP for short-term and long-term mortality of acute intracerebral hemorrhage (ICH) patients. Methods: A total of 150 patients and 150 age- and gender- matched healthy controls were recruited. The plasma PACAP concentrations were measured using sandwich immunoassays. ICH severity was assessed using hematoma volume and National Institutes of Health Stroke Scale (NIHSS) score. The end points included 1-week mortality and 6-month mortality. The relationships between plasma PACAP concentrations and ICH severity and the end points were analyzed statistically. Results: Plasma PACAP concentrations were statistically significantly higher in the ICH patients than in the healthy controls and were correlated positively with hematoma volumes and NIHSS scores using a multivariate linear regression. Multivariate analysis results indicated that plasma PACAP concentration was an independent predictor of 1-week mortality, 6-month mortality and 6-month overall survival. It also had high predictive value based on receiver operating characteristic curve. Conclusions: Plasma PACAP concentrations are increased and are highly associated with the severity of ICH; PACAP may be a good predictor of short-term and long-term mortality of ICH. (C) 2014 Elsevier B.V. All rights reserved.