Exploring Novel Biomarkers and Their Impact on Long-term Outcomes in Status Epilepticus
Abstract number :
3.209
Submission category :
2. Translational Research / 2C. Biomarkers
Year :
2024
Submission ID :
871
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Estevo Santamarina, MD, PhD – Vall d'Hebron University Hospital
Daniel Campos-Fernandez, MD – Vall d'Hebron University Hospital
Laura Abraira, MD PhD – Epilepsy Unit, Department of Neurology, Vall d’Hebron Hospital Universitari, Barcelona; Universitat Autonoma de Barcelona, Bellaterra, Spain
Manuel Quintana, PhD – Vall d'Hebron University Hospital
Anna Penalba, MSN – Vall Hebron Institute Research
Elena Fonseca, MD, PhD – Vall d'Hebron University Hospital
Samuel Lopez-Maza, MD – Hospital Vall Hebron
Manuel Toledo, MD, PhD – Vall d'Hebron University Hospital
Rationale: Predicting mortality and certain long-term outcomes after status epilepticus (SE), such as the onset of chronic epilepsy, remains a significant challenge. Although several biological markers have been linked to status outcomes, including mortality and functional status, none have been associated with the recurrence of seizures.
This study aimed to evaluate the potential of new serum biomarkers in predicting mortality and the development of epilepsy during long-term follow-up.
Methods: We selected serum samples from a prospective database encompassing patient presenting with suspected epileptic seizures at the Emergency Department between June 2020-June 2022. Clinical and etiological variables from the acute phase were included, along with follow-up data at discharge and at one-year intervals, including information on the recurrence of epileptic seizures. Levels of S100B, enolase, HMGB1, APOC4, BAND3 (SLC4A1), CADH-1, IGHG2, and SRC were quantified based on previous findings and relevant literature.
Results: The study identified samples from 80 patients diagnosed with SE, with a mean age of 66.2 ± 15.5 years and a female representation of 45%. The majority had an acute symptomatic etiology (n=37, 46.3%), with 21 cases (26.3%) classified as delayed symptomatic, 15 (18.8%) as progressive, and 7 (8.8%) of unknown etiology. Of these, 45 cases (56.35%) were considered refractory. The mean follow-up duration was 14.8 months (SD 13.5). The mortality rate was 50.6%, and 45.7% of patients experienced unprovoked seizures. Logistic regression analysis using optimal cutoff points for mortality revealed significantly elevated values for CADH-1 (p=0.004), S100B (p=0.055), and enolase (p=0.031). When combined with clinical variables, only high levels of S100B and enolase remained independent factors. For post-SE epilepsy development, CADH-1 levels (p=0.023) were significantly lower in those experiencing unprovoked seizures during follow-up. This biomarker retained significance when combined with clinical variables.
Conclusions: Biomarker detection can be valuable for long-term prognosis following status epilepticus. S100B and enolase are associated with long-term mortality, while CADH-1 is linked to the occurrence of unprovoked seizures during follow-up.
Funding: Spanish Ministry of Health - ISCIII (Instituto Carlos III). PI19/01575
Translational Research