Oxidative stress and early mortality in acute ischemic stroke: A prospective cohort study.
| Autor: | Elhamrawy EA; Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Shoman H; Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Abdel-Tawab H; Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Bahbah EI; Faculty of Medicine, Al-Azhar University, Damietta, Egypt., Elattar RS; Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Hussein NR; Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Sonbol M; Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Elsheikh AA; Department of Community and Occupational Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. |
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| Jazyk: | angličtina |
| Zdroj: | Neurological research [Neurol Res] 2023 Nov; Vol. 45 (11), pp. 1003-1010. Date of Electronic Publication: 2023 Aug 31. |
| DOI: | 10.1080/01616412.2023.2252284 |
| Abstrakt: | Background: Malondialdehyde (MDA) is an oxidative stress biomarker, which represents a unifying mechanism of brain injury that occurs throughout the ischemic stroke cascade. The current study aimed to examine whether or not acute ischemic stroke (AIS) patients who had elevated serum MDA levels at admission had an increased risk of mortality and a worse functional outcome three months later. Methods: An observational, prospective cohort study that enrolled 90 patients with AIS. The patients were examined in the first 24 hours and then followed up for three months to assess mortality, short-term neurological functional outcome, and neurological disability by the Modified Rankin Scale (MRS). Results: The mean of serum MDA level among AIS patients was 6.3 ± 3.7 nmol/ml. Non-survivor cases were associated with statistically significantly higher serum MDA levels compared to survivors (9.7 ± 4.3 vs. 5.3 ± 2.8, p < 0.001), respectively. Patients with severe stroke, according to NIHSS score, were associated with significantly ( p < 0.05) higher MDA levels compared to moderate and mild cases (7.4 ± 4.3 vs. 5.4 ± 2.6 vs. 3.3 ± .6). At a cutoff point of ≥ 6.7 nmol/ml, the area under the curve (AUC) for serum MDA levels as a predictor of mortality was 0.8 (0.69-0.91; p < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value were 77%, 80%, 89.5%, and 48.5%, respectively. Multivariate regression demonstrated that MDA level was a significant independent predictor of mortality among patients with AIS (OR = 1.29, 95% CI: 1.01 to 1.65; p = 0.041). Conclusion: MDA serum level was significantly higher in non-survivors than in survivors patients, so MDA could be used as a predictor for early mortality and short-term outcome of cases with AIS. |
| Databáze: | MEDLINE |
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