Caspase-3 in serum predicts outcome after aneurysmal subarachnoid hemorrhage.

BACKGROUND

Caspase-3 represents a promising marker of apoptosis. This study was designed to investigate the serial change of serum caspase-3 activities and analyze the relationships between caspase-3 activities and the severity and prognosis of aneurysmal subarachnoid hemorrhage (aSAH).

METHODS

We determined serum caspase-3 activities of 118 controls at study entry and 118 patients at admission and at days 1, 2, 3, 5 and 7 after aSAH. Activities were compared with regard to (i) time interval between onset of symptoms and blood sampling, (ii) stroke severity quantified by World Federation of Neurological Surgeons (WFNS) scores and modified Fisher scores and (iii) 6-month outcome.

RESULTS

Serum caspase-3 activities were increased after aSAH, peaked at day 3, gradually decreased afterwards, and substantially were higher in patients than in controls. Caspase-3 activities were higher in patients suffering from death or an unfavorable outcome (Glasgow Outcome Scale score of 1-3), had close relation to WFNS scores and modified Fisher scores, and possessed high areas under receiver operating characteristic curve. Moreover, caspase-3 activities at admission and at day 3 predicted poor outcome independently of age, WFNS scores and modified Fisher scores.

CONCLUSION

Increased serum caspase-3 activities are highly associated with the severity and prognosis after aSAH.