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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
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