Body iron stores and early neurologic deterioration in acute cerebral infarction
- 25 April 2000
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 54 (8), 1568-1574
- https://doi.org/10.1212/wnl.54.8.1568
Abstract
Background: Iron-dependent free radicals formation has been related to greater damage in cerebral ischemia. The authors analyzed whether increased body iron stores were associated with early neurologic worsening and excitatory amino acid release in patients with acute ischemic stroke. Methods: Ferritin, total iron, and glutamate concentrations in plasma and CSF were measured on admission in 100 consecutive patients with a cerebral infarction of Results: Ferritin concentrations in plasma (median 391, range 119 to 500 versus 148, 21 to 399 ng/mL) and in CSF (17.4, 6.8 to 82, versus 4.8, 0.6 to 14 ng/mL) were significantly higher in the 45 patients with subsequent progressing stroke than in those with nonprogressing stroke (p < 0.001). There was a positive correlation between ferritin and glutamate concentrations in plasma (r = 0.81, p < 0.001) and CSF (r = 0.64, p < 0.001). Plasma ferritin concentrations >275 ng/mL in plasma (OR, 33.5; 95% CI, 4.7 to 235) and >11 ng/mL in CSF (OR, 11.4; 95% CI, 3.1 to 41) were independently and significantly related to early neurologic worsening. The effect was reduced by >60% after controlling for glutamate concentrations, but remained significant. Conclusions: High plasma and CSF ferritin concentrations within the first 24 hours from the onset of ischemic stroke are associated with early neurologic deterioration. Increased body iron stores may contribute to stroke progression by enhancing the cytotoxic mechanisms in cerebral ischemia.Keywords
This publication has 33 references indexed in Scilit:
- Neurological Deterioration in Acute Ischemic StrokeStroke, 1999
- Early Spontaneous Improvement and Deterioration of Ischemic Stroke PatientsStroke, 1998
- Low Molecular Weight Iron in Cerebral Ischemic Acidosis In VivoStroke, 1998
- Serum Ferritin Concentrations Are Not Modified in the Acute Phase of Ischemic StrokeStroke, 1998
- Duration of Glutamate Release After Acute Ischemic StrokeStroke, 1997
- Parallel Antioxidant and Antiexcitotoxic Therapy Improves Outcome After Incomplete Global Cerebral Ischemia in DogsStroke, 1997
- Role of Oxidants in Ischemic Brain DamageStroke, 1996
- Ischemia-induced brain iron delocalization: Effect of iron chelatorsFree Radical Biology & Medicine, 1994
- Iron depletion or chelation reduces ischemia/reperfusion-induced edema in gerbil brainsJournal of Pediatric Surgery, 1990
- The Canadian Neurological Scale: a preliminary study in acute stroke.Stroke, 1986