A prospective cohort study on serum PINK1 as a biochemical marker in relation to poor neurological prognosis, stroke-associated pneumonia and early neurological deterioration after acute intracerebral hemorrhage

Abstract

Background: PTEN-induced putative kinase 1 (PINK1) may moderate neurodegeneration via sustaining mitochondrial function and integrity. Here, we attempted to determine relationship between serum PINK1 levels, disease severity, poor prognosis, Early Neurological Deterioration (END) and Stroke-Associated Pneumonia (SAP) following acute Intracerebral Hemorrhage (ICH).

Methods: Altogether, 175 patients with ICH and 80 controls were encompassed in this prospective cohort study. Serum PINK1 levels were measured at admission of all patients and at study entry of all controls. The National Institutes of Health Stroke Scale (NIHSS) scores and hematoma volumes were applied to determine the severity. SAP, END and post-ICH 6-month poor prognosis (modified Rankin Scale scores: 3-6) were recorded as the three outcome variables of interest.

Results: Patients, in contrast to controls, had significantly elevated serum PINK1 levels. Serum PINK1 levels were independently correlated with NIHSS scores, hematoma volumes and 6-month modified Rankin Scale scores. Serum PINK1 levels were linearly correlated with risks of SAP, END and post-ICH 6-month poor prognosis under the restricted cubic spline, as well as along with NIHSS scores and hematoma volumes, became their independent predictors. As demonstrated under receiver operating characteristic curve, serum PINK1 levels displayed effective predictive ability and possessed similar discrimination efficiency, when compared to NIHSS scores and hematoma volumes. Using sensitivity analysis, prognosis association was robust.

Conclusion: Serum PINK1 levels are substantially heightened after ICH, and may accurately mirror hemorrhagic intensity and efficaciously forecast END, SAP, and poor neurological prognosis, signifying that PINK1 may be a serological prognosticator of good prospect in ICH.

Keywords: Biomarkers; Early neurological deterioration; Intracerebral hemorrhage; PTEN-induced putative kinase 1; Prognosis; Severity; Stroke-associated pneumonia.