ABSTRACT NUMBER: ESOC2026A2031 PLASMA BIOMARKERS IN DELAYED CEREBRAL ISCHEMIA AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

Abstract Background and aims An aneurysmal subarachnoid haemorrhage (aSAH) is a life-threatening neurovascular emergency. Among survivors of the initial insult, the most feared complication is Delayed Cerebral Ischemia (DCI), affecting approximately 30% of aSAH patients. Several mechanisms responsible for DCI development have been described. We have recently hypothesized that the endothelial glycocalyx plays a key role in these pathomechanisms. The aim of the current study is to assess whether glycocalyx breakdown precedes DCI following aSAH. Methods We prospectively obtained blood plasma samples during a two-week follow up period after aSAH diagnosis. We specifically evaluated Syndecan-1 and Hyaluronan levels, both are glycocalyx breakdown products, using commercially available ELISA kits. Results A total of 30 aSAH patients were included in this study, of which 7 developed DCI. Syndecan-1 as well as Hyaluronan showed a time-dependent increase between baseline measurement and two weeks post-ictus. This increase was more pronounced in in DCI patients compared to non-DCI patients. Conclusions Increased plasma concentrations of Syndecan-1 and Hyaluronan over two weeks post-ictus suggest that glycocalyx breakdown plays a role in aSAH and DCI development. This study needs extension and external validation to strengthen our results, and establish the potential of glycocalyx breakdown products as biomarkers for DCI. Conflict of interest K Aslankurt: nothing to declare, H Schenck: nothing to declare S van Kuijk: nothing to declare, E Gommer: nothing to declare, W Mess: nothing to declare, I de Ridder; nothing to declare, R van Lanen; nothing to declare, O Teernstra: nothing to declare, J Dings; nothing to declare, M Veldeman: nothing to declare, M Aries: nothing to declare, M Aries: nothing to declare, H Vink: is co-founder of the GlycoCalyx Research Institute and GlycoCheck, Y Temel: nothing to declare, R Haeren: nothing to declare