DCI after Aneurysmal Subarachnoid Hemorrhage Is Related to the Expression of MFG-E8

Abstract

Objective. To explore the predictive value of milk fat globule epidermal growth factor 8 (MFG-E8) in the occurrence of delayed cerebral ischemia (DCI) after an aneurysmal subarachnoid hemorrhage (aSAH). Methods. We recruited 32 patients with aSAH as the case group and 24 patients with unruptured aneurysms as the control group. Serum MFG-E8 levels were measured by western blot and enzyme-linked immunosorbent assay. We analyzed the relationship between MFG-E8 levels and the risk of DCI. Results. The levels of serum MFG-E8 in the case group ( $\text{mean}=11160.9$  pg/mL) were significantly higher than those in the control group ( $\text{mean}=3081.0$  pg/mL, $p<0.001$ ). MFG-E8 levels highly correlated with the World Federation of Neurosurgical Societies (WFNS) and modified Fisher scores ( $r=-0.691\text{and}-0.767$ , respectively, $p<0.001$ ). In addition, MFG-E8 levels in patients with DCI ( $5882.7\pm 3162.4$  pg/mL) were notably higher than those in patients without DCI ( $15818.2\pm 3771.6$  pg/mL, $p<0.001$ ). A receiver operating characteristic curve showed that the occurrence of DCI could effectively be predicted by MFG-E8 (area under the $\text{curve}=0.976$ , $95\%\text{CI}=0.850–1.000$ ). Kaplan–Meier survival analysis showed a remarkable decrease in the incidence of DCI in case group individuals with high levels of MFG-E8 (≥11160.9 pg/mL, $p<0.001$ ). Conclusion. MFG-E8 may be a useful predictive marker for DCI after an aSAH and could be a promising surrogate end point.