Abstract
Substance P (SP), a member of tachykinin family, is involved in the inflammation of the central nervous system and in the appearance of cerebral edema. Higher serum levels of SP have been found in 18 patients with cerebral ischemia compared with healthy controls. The aim of our multi-center study was to analyze the possible association between serum levels of SP and mortality in ischemic stroke patients. We included patients with malignant middle cerebral artery infarction (MMCAI) and a Glasgow Coma Scale (GCS) lower than 9. Non-surviving patients at 30 days (n = 31) had higher serum concentrations of SP levels at diagnosis of severe MMCAI than survivors (n = 30) (p < 0.001). We found in multiple regression an association between serum concentrations of SP higher than 362 pg/mL and mortality at 30 days (Odds Ratio = 5.33; 95% confidence interval = 1.541–18.470; p = 0.008) after controlling for age and GCS. Thus, the major novel finding of our study was the association between serum levels of SP and mortality in patients suffering from severe acute ischemic stroke.
Highlights
Ischemic stroke is associated with considerable resource consumption, disability, and mortality [1]
Regression analysis showed an association between serum levels of Substance P (SP) higher than 362 pg/mL and mortality at 30 days (Odds Ratio = 5.33; 95% confidence interval = 1.541–18.470; p = 0.008) after adjusting for Glasgow Coma Scale (GCS) and age (Table 2)
The major novel findings were that non-surviving patients with severe malignant middle cerebral artery infarction (MMCAI) had higher serum concentrations of SP than survivors, and that an association between serum concentrations of SP and mortality exists in MMCAI patients
Summary
Ischemic stroke is associated with considerable resource consumption, disability, and mortality [1]. Cell death occurs due to vascular obstruction and the restriction of blood that contains oxygen and substrates for neurons. There may be secondary injury (due to different mechanisms, such as inflammation, apoptosis, oxidative stress, increased vascular permeability, and cerebral edema), which could contribute to increased cell death [2,3]. The tachykinin family includes different members as substance P (SP), neurokinin B (NKB), neurokinin A (NKA), and endokinins [4,5,6,7,8,9].
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