Cargando…
Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients
Objective: The activation of different physiopathological pathways (neuroinflammation, apoptosis, and oxidation) can lead to secondary brain injury in ischemic stroke, and in animal models the administration of melatonin has reduced that secondary injury. Lower levels of serum melatonin were found a...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955878/ https://www.ncbi.nlm.nih.gov/pubmed/31795260 http://dx.doi.org/10.3390/brainsci9120346 |
_version_ | 1783487030321217536 |
---|---|
author | Lorente, Leonardo Martín, María M. Abreu-González, Pedro Sabatel, Rafael Ramos, Luis Argueso, Mónica Solé-Violán, Jordi Cáceres, Juan J. Jiménez, Alejandro García-Marín, Victor |
author_facet | Lorente, Leonardo Martín, María M. Abreu-González, Pedro Sabatel, Rafael Ramos, Luis Argueso, Mónica Solé-Violán, Jordi Cáceres, Juan J. Jiménez, Alejandro García-Marín, Victor |
author_sort | Lorente, Leonardo |
collection | PubMed |
description | Objective: The activation of different physiopathological pathways (neuroinflammation, apoptosis, and oxidation) can lead to secondary brain injury in ischemic stroke, and in animal models the administration of melatonin has reduced that secondary injury. Lower levels of serum melatonin were found at the time of admission of cerebral infarction in surviving patients than in non-surviving patients. Thus, we carried out this prospective and observational study with the aim of exploring serum melatonin levels in the first week of a malignant middle cerebral artery infarction (MMCAI) in surviving and non-surviving patients, and to explore the capacity of those levels to predict mortality. Methods: Patients with severe MMCAI, defined as computed tomography showing acute infarction in more than 50% of the territory and Glasgow Coma Scale (GCS) lower than 9, were included in the study. We measured serum melatonin concentrations at days 1, 4, and 8 of MMCAI. Mortality at 30 days was the endpoint of our study. Results: Non-surviving patients (n = 34) compared to surviving patients (n = 34) showed higher serum melatonin levels at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.001) of MMCAI. Serum melatonin concentrations at days 1, 4, and 8 of MMCAI had an area under the curve (AUC) (95% confidence interval (CI)) in the prediction of mortality of 0.89 (0.80–0.96; p < 0.001), 0.81 (0.68–0.91; p < 0.001), and 0.82 (0.68–0.92; p < 0.001), respectively. Conclusions: The novel findings of our study were that serum melatonin levels in the first week of MMCAI were higher in non-surviving patients, and were able to predict mortality. |
format | Online Article Text |
id | pubmed-6955878 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-69558782020-01-23 Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients Lorente, Leonardo Martín, María M. Abreu-González, Pedro Sabatel, Rafael Ramos, Luis Argueso, Mónica Solé-Violán, Jordi Cáceres, Juan J. Jiménez, Alejandro García-Marín, Victor Brain Sci Article Objective: The activation of different physiopathological pathways (neuroinflammation, apoptosis, and oxidation) can lead to secondary brain injury in ischemic stroke, and in animal models the administration of melatonin has reduced that secondary injury. Lower levels of serum melatonin were found at the time of admission of cerebral infarction in surviving patients than in non-surviving patients. Thus, we carried out this prospective and observational study with the aim of exploring serum melatonin levels in the first week of a malignant middle cerebral artery infarction (MMCAI) in surviving and non-surviving patients, and to explore the capacity of those levels to predict mortality. Methods: Patients with severe MMCAI, defined as computed tomography showing acute infarction in more than 50% of the territory and Glasgow Coma Scale (GCS) lower than 9, were included in the study. We measured serum melatonin concentrations at days 1, 4, and 8 of MMCAI. Mortality at 30 days was the endpoint of our study. Results: Non-surviving patients (n = 34) compared to surviving patients (n = 34) showed higher serum melatonin levels at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.001) of MMCAI. Serum melatonin concentrations at days 1, 4, and 8 of MMCAI had an area under the curve (AUC) (95% confidence interval (CI)) in the prediction of mortality of 0.89 (0.80–0.96; p < 0.001), 0.81 (0.68–0.91; p < 0.001), and 0.82 (0.68–0.92; p < 0.001), respectively. Conclusions: The novel findings of our study were that serum melatonin levels in the first week of MMCAI were higher in non-surviving patients, and were able to predict mortality. MDPI 2019-11-28 /pmc/articles/PMC6955878/ /pubmed/31795260 http://dx.doi.org/10.3390/brainsci9120346 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lorente, Leonardo Martín, María M. Abreu-González, Pedro Sabatel, Rafael Ramos, Luis Argueso, Mónica Solé-Violán, Jordi Cáceres, Juan J. Jiménez, Alejandro García-Marín, Victor Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients |
title | Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients |
title_full | Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients |
title_fullStr | Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients |
title_full_unstemmed | Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients |
title_short | Higher Serum Melatonin Levels during the First Week of Malignant Middle Cerebral Artery Infarction in Non-Surviving Patients |
title_sort | higher serum melatonin levels during the first week of malignant middle cerebral artery infarction in non-surviving patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955878/ https://www.ncbi.nlm.nih.gov/pubmed/31795260 http://dx.doi.org/10.3390/brainsci9120346 |
work_keys_str_mv | AT lorenteleonardo higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT martinmariam higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT abreugonzalezpedro higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT sabatelrafael higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT ramosluis higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT arguesomonica higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT soleviolanjordi higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT caceresjuanj higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT jimenezalejandro higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients AT garciamarinvictor higherserummelatoninlevelsduringthefirstweekofmalignantmiddlecerebralarteryinfarctioninnonsurvivingpatients |