Abstract
ObjectivePreviously there have been found higher circulating malondialdehyde levels during the first week of ischemic stroke in patients with worst neurological functional outcome, and at moment of ischemic stroke in non-survivor patients. Thus, the aim of our study was to determine the potential role of serum malondialdehyde levels during the first week of a severe cerebral infarction to mortality prediction.MethodsThis study was observational, prospective, and multicenter. We included patients with a severe malignant middle cerebral artery infarction (MMCAI) defined as patients with computed tomography showing acute infarction in more than of 50% of the territory and Glasgow Coma Scale (GCS) lower than 9. We determined serum concentrations of malondialdehyde on days 1, 4 and 8 of MMCAI.ResultsSerum malondialdehyde concentrations at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.001) of MMCAI in non-survivor patients (n = 34) were higher than in survivor patients (n = 34). ROC curve analyses showed that serum malondialdehyde concentrations at days 1, 4, and 8 of MMCAI had an AUC (95% CI) to predict 30-day mortality of 0.77 (0.65–0.86; p < 0.001), 0.82 (0.69–0.91; p < 0.001) and 0.84 (0.70–0.93; p < 0.001) respectively.ConclusionsThe new findings of our study were that serum malondialdehyde levels during the first week of MMCAI could be used as biomarkers to mortality prediction.
Highlights
A large quantity of disabilities, deaths and resources consumption are generated by ischemic stroke [1]
Receiver operating characteristic (ROC) analyses were used to determine the capacity for 30-day mortality prediction by serum malondialdehyde levels at day 1, 4 and 8 of malignant middle cerebral artery infarction (MMCAI)
Area under curve (AUC), and sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predicted value and negative predicted value of serum malondialdehyde levels cut-offs for mortality prediction are showed with its 95% confidence intervals (CI)
Summary
A large quantity of disabilities, deaths and resources consumption are generated by ischemic stroke [1]. In addition to cell death produced by brain vasculature obstruction that causes a reduction of blood containing oxygen and substrates to neurons, could appears a secondary brain injury mediated by oxidative stress [2,3,4,5,6]. Afterwards malondialdehyde could be released to extracellular space and appears in the blood; and circulating malondialdehyde levels have been used as lipid oxidation biomarker [7, 8]. Have been found higher circulating malondialdehyde levels during the first week of ischemic stroke in patients with worst neurological functional outcome [9,10,11,12], and at moment of ischemic stroke in nonsurvivor patients [13, 14]. The aim of our study was to determine the potential role of serum malondialdehyde levels during the first week of a severe cerebral infarction to mortality prediction
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