{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:17:10Z","timestamp":1789042630991,"version":"build-2803163510"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Delayed cerebral ischemia (DCI) after spontaneous subarachnoid hemorrhage (SAH) is not well understood. Recent studies suggest the involvement of neutrophil\u2010mediated immunothrombosis via neutrophil extracellular traps (NETs). We aimed to assess whether trajectories of NET biomarkers in patients with acute SAH are associated with DCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This was a prospective single\u2010center study of patients within 48 hours of SAH onset. We collected clinical, laboratory, imaging, and 3\u2010month outcome data. NET markers (H3Cit [citrullinated histone H3]\u2010DNA complexes, myeloperoxidase\u2010DNA complexes, cell\u2010free DNA), along with peptidylarginine deiminase 4, and deoxyribonuclease activity were measured in plasma collected on admission (baseline), and post\u2010SAH days 5 and 10. DCI was defined by clinical and imaging criteria. Generalized estimating equations examined differences in NET trajectories comparing patients with and without DCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We enrolled 40 patients with SAH (mean age, 57\u2009years; n=21 [53%] women; 32 [80%] aneurysmal). DCI occurred in 12 (30%) patients. All NET levels were similar between groups at baseline. On day 5, those with DCI compared with those without DCI had elevated median H3Cit\u2010DNA complex (63\u2009ng\/mL versus 31\u2009ng\/mL,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.049), myeloperoxidase\u2010DNA complex (5.9\u2009ng\/mL versus 0.4 ng\/mL,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.029), and cell\u2010free DNA (651 ng\/mL versus 515 ng\/mL,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.04) levels, which trended back down on day 10. In the DCI group, generalized estimating equations indicated heightened trajectories of H3Cit\u2010DNA complex (day 5 [compared with baseline]: \u03b2=0.7; SE, 0.3;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.01; day 10: \u03b2=0.5; SE, 0.3;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.09), and myeloperoxidase\u2010DNA complex levels (day 5: \u03b2=3.1; SE, 0.4;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; day 10: \u03b2=1.6; SE, 1.0;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients with acute SAH, elevated plasma trajectories of NETs are associated with DCI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.041325","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T11:14:56Z","timestamp":1758280496000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Neutrophil Extracellular Traps and Delayed Cerebral Ischemia in Patients With Subarachnoid Hemorrhage"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9641-0922","authenticated-orcid":false,"given":"Hauke","family":"Schneider","sequence":"first","affiliation":[{"name":"University Hospital Augsburg","place":["Augsburg, Germany"]},{"name":"TUD Dresden University of Technology","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"M\u00fcnch","sequence":"additional","affiliation":[{"name":"University Hospital Augsburg","place":["Augsburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4937-5810","authenticated-orcid":false,"given":"Val\u00e9rie","family":"Spalart","sequence":"additional","affiliation":[{"name":"KU Leuven","place":["Leuven, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7018-3081","authenticated-orcid":false,"given":"Mathias","family":"Stroobants","sequence":"additional","affiliation":[{"name":"KU Leuven","place":["Leuven, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5321-5118","authenticated-orcid":false,"given":"Ansgar","family":"Berlis","sequence":"additional","affiliation":[{"name":"University Hospital Augsburg","place":["Augsburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-0797","authenticated-orcid":false,"given":"Christoph J.","family":"Maurer","sequence":"additional","affiliation":[{"name":"University Hospital Augsburg","place":["Augsburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3318-0234","authenticated-orcid":false,"given":"Ulrich","family":"Jaschinski","sequence":"additional","affiliation":[{"name":"University Hospital Augsburg","place":["Augsburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0418-6917","authenticated-orcid":false,"given":"Scott E.","family":"Kasner","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6204-1305","authenticated-orcid":false,"given":"Quy","family":"Cao","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1026-6107","authenticated-orcid":false,"given":"Kimberly","family":"Martinod","sequence":"additional","affiliation":[{"name":"KU Leuven","place":["Leuven, Belgium"]},{"name":"University of Rochester Medical Center","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-851X","authenticated-orcid":false,"given":"Jens","family":"Witsch","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, 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