Correlation of plasma plectin levels with small intracranial aneurysms instability and prognosis

The study aimed to explore the correlation between plasma plectin (PLEC) level and instability of small intracranial aneurysms (sIA; ≤ 7 mm), as well as its relationship with the prognosis of patients with small ruptured intracranial aneurysm (sRIA). A total of 360 individuals were recruited from May 2021 to June 2023, including 139 sRIA patients, 110 small unruptured intracranial aneurysm (sUIA) patients, 58 traumatic subarachnoid hemorrhage (tSAH) patients and 53 healthy controls (HC). Plasma PLEC levels were detected by ELISA. Logistic regression analysis was used to determine independent risk factors. The ROC curve was utilized to assess the performance in distinguishing the unstable state of aneurysms and predicting the 3-month poor prognosis. ELISA revealed elevated plasma PLEC in sRIA patients vs. sUIA, tSAH, and HC. The PLEC serves as an independent risk factor for sIA instability, with a cut-off value of 76.8 ng/ml. When the cut-off value of 76.8 ng/mL was used to distinguish sRIA from asymptomatic UIA, the sensitivity was 77.5%, the specificity was 54.3%, and the accuracy was 72.0%. Meanwhile, the sensitivity, specificity, and accuracy for distinguishing symptomatic UIA from asymptomatic UIA were 84.6%, 51.4%, and 73.0%, respectively. Plasma PLEC levels were negatively correlated with GCS scores and positively correlated with Fisher and Hunt-Hess grade. The PLEC can also serve as an independent predictor of 3-month poor outcome in sRIA patients. When the level of plasma PLEC was combined with GCS score, Fisher grade, and Hunt-Hess grade to predict the 3-month poor outcome of sRIA patients, the AUC can be improved to 0.965 (Sensitivity: 90.0%, Specificity: 89.7%). The PLEC level in peripheral blood of sRIA patients was significantly higher than that of sUIAs, tSAHs and HCs. The plasma PLEC level related with unstable IA status and may function as a potential biomarker for sIA instability. Plasma PLEC serves as an early warning plasma marker for 3-month poor prognosis after aneurysmal subarachnoid hemorrhage (aSAH). Clinical trial number Not applicable.