Potential Role of Serum S-100β Protein as a Predictor of Cardiotoxicity and Clinical Poor Outcome in Acute Amphetamine Intoxication

• Published in: Cardiovascular toxicology Vol. 21; no. 5; pp. 375 - 386
• Main Authors: Sharif, Asmaa F., Elsheikh, Eman, Al-Asmari, Abdullah Z., Gameel, Dina El
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2021; Springer Nature B.V
• Subjects: Adolescent; Adult; Amphetamine - adverse effects; Amphetamines; Biomarkers - blood; Biomedical and Life Sciences; Biomedicine; Cardiology; Cardiotoxicity; Central Nervous System Stimulants - adverse effects; Cross-Sectional Studies; Enzyme-Linked Immunosorbent Assay; Exposure; Female; Gas Chromatography-Mass Spectrometry; Heart Diseases - blood; Heart Diseases - diagnosis; Heart Diseases - etiology; Heart Diseases - therapy; Hospitalization; Humans; Intoxication; Male; Middle Aged; Morbidity; Neurotoxicity; Neurotoxicity Syndromes - blood; Neurotoxicity Syndromes - diagnosis; Neurotoxicity Syndromes - etiology; Neurotoxicity Syndromes - therapy; Patients; Pharmacology/Toxicology; Predictive Value of Tests; Prognosis; Prospective Studies; S100 Calcium Binding Protein beta Subunit - blood; Saudi Arabia; Serum levels; Toxicity; Up-Regulation; Young Adult; Saudi Arabia; S-100β; QTc interval; Neurotoxicity; Amphetamine; Cardiotoxicity
• ISSN: 1530-7905; 1559-0259
• DOI: 10.1007/s12012-020-09630-1

Cardio- and neurotoxicity of amphetamines play an important role in worsening morbidity, making the initial evaluation of the patient’s status a potentially lifesaving action. The current study hypothesized that the S-100β serum level could predict the severity of acute amphetamine toxicity and the in-hospital outcome. The current study is a prospective cohort study conducted on 77 patients diagnosed with acute amphetamine exposure and referred to Aseer Poison Control Center, Saudi Arabia. The patients admitted to ICU showed significantly higher serum levels of S-100β in comparison to those not admitted ( p  < 0.05). Moreover, the S-100β level was significantly elevated among patients with prolonged QTc intervals. Receiver-operating characteristic curve of S-100β serum level as an in-hospital outcome predictor showed that at a cutoff value > 0.430 ug/L, the sensitivity of S-100β serum level as severity predictor was 100%, and the specificity was 74.1%. In conclusion, the current study revealed that the S-100β serum level could be used as an outcome predictor in hospital admission cases due to toxic amphetamine exposure and offers an idea about the cardiac and neuronal involvement. This can help select patients who will benefit most from ICU admission and early management and assess the severity of cases in settings where GC–MS is not available.