Asymmetric dimethylarginine in response to recombinant tissue-type plasminogen activator and erythropoietin in acute stroke
| Autor: | Stefanie M. Bode-Böger, Ralf Lichtinghagen, Hannelore Ehrenreich, Jan T. Kielstein, Hans Worthmann, Hartmut Hecker, Na Li, Karin Weissenborn, Jens Martens-Lobenhoffer, Majed Joumaah |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Endogeny Placebo Arginine Gastroenterology Severity of Illness Index chemistry.chemical_compound Double-Blind Method Internal medicine medicine Humans Thrombolytic Therapy Stroke Erythropoietin Aged Advanced and Specialized Nursing Aged 80 and over business.industry Thrombolysis Middle Aged medicine.disease Clinical trial Treatment Outcome chemistry Anesthesia Tissue Plasminogen Activator Acute Disease Drug Therapy Combination Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Asymmetric dimethylarginine Plasminogen activator medicine.drug |
| Zdroj: | Stroke. 44(8) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose— In the German Multicenter Erythropoietin (EPO) Stroke Trial, patients not receiving thrombolysis most likely benefited from EPO on clinical recovery, whereas a combination of rtPA and EPO was associated with increased mortality. We investigated whether the combination of rtPA and EPO increased release of the endogenous NO synthase inhibitor asymmetric dimethylarginine (ADMA), and thereby potentially deteriorated ischemic stroke outcome, as suggested from experimental data. Methods— ADMA was determined in serum samples from 90 patients of the German Multicenter EPO Stroke Trial taken at days 1 (within 6 hours after symptom onset), 2, 3, 4, and 7 after stroke using high-performance liquid chromatography–tandem mass spectrometry. ADMA was analyzed for the different treatment groups (EPO, n=25; placebo, n=30; rtPA+placebo, n=18; EPO+rtPA, n=17). Clinical outcome was expressed as difference between National Institutes of Health Stroke Scale at baseline and 90 days. Results— ADMA levels significantly increased during the observation time in EPO, EPO+rtPA, and placebo groups ( P P =0.027). Here, ADMA levels were decreased compared with the placebo group ( P P Conclusions— Our data underscore the potential benefit of EPO in ischemic stroke. The hypothesis from experimental data, that EPO treatment increases ADMA in stroke patients, was disproved. Further studies are needed to clarify whether decreased ADMA might contribute to therapeutic rtPA effects. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|