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Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery

Malignant infarction of the middle cerebral artery (m-MCA) is a complication of ischemic stroke. Since hyperthermia is a predictor of poor outcome, and antihyperthermic treatment is well tolerated, our main aim was to analyze whether the systemic temperature decrease within the first 24 h was associ...

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Autores principales: Alonso-Alonso, Maria Luz, Sampedro-Viana, Ana, Rodríguez-Yáñez, Manuel, López-Dequidt, Iria, Pumar, José M., Mosqueira, Antonio J., Ouro, Alberto, Ávila-Gómez, Paulo, Sobrino, Tomás, Campos, Francisco, Castillo, José, Hervella, Pablo, Iglesias-Rey, Ramón
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146428/
https://www.ncbi.nlm.nih.gov/pubmed/35629002
http://dx.doi.org/10.3390/jcm11102874
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author Alonso-Alonso, Maria Luz
Sampedro-Viana, Ana
Rodríguez-Yáñez, Manuel
López-Dequidt, Iria
Pumar, José M.
Mosqueira, Antonio J.
Ouro, Alberto
Ávila-Gómez, Paulo
Sobrino, Tomás
Campos, Francisco
Castillo, José
Hervella, Pablo
Iglesias-Rey, Ramón
author_facet Alonso-Alonso, Maria Luz
Sampedro-Viana, Ana
Rodríguez-Yáñez, Manuel
López-Dequidt, Iria
Pumar, José M.
Mosqueira, Antonio J.
Ouro, Alberto
Ávila-Gómez, Paulo
Sobrino, Tomás
Campos, Francisco
Castillo, José
Hervella, Pablo
Iglesias-Rey, Ramón
author_sort Alonso-Alonso, Maria Luz
collection PubMed
description Malignant infarction of the middle cerebral artery (m-MCA) is a complication of ischemic stroke. Since hyperthermia is a predictor of poor outcome, and antihyperthermic treatment is well tolerated, our main aim was to analyze whether the systemic temperature decrease within the first 24 h was associated with a better outcome. Furthermore, we studied potential biochemical and neuroimaging biomarkers. This is a retrospective observational analysis that included 119 patients. The temperature variations within the first 24 h were recorded. Biochemical laboratory parameters and neuroimaging variables were also analyzed. The temperature increase at the first 24 h (OR: 158.97; CI 95%: 7.29–3465.61; p < 0.001) was independently associated with a higher mortality. Moreover, antihyperthermic treatment (OR: 0.08; CI 95%: 0.02–0.38; p = 0.002) was significantly associated with a good outcome at 3 months. Importantly, antihyperthermic treatment was associated with higher survival at 3 months (78% vs. 50%, p = 0.003). Significant independently associations between the development of m-MCA and both microalbuminuria (OR: 1.01; CI 95%: 1.00–1.02; p = 0.005) and leukoaraiosis (OR: 3.07; CI 1.84–5.13–1.02; p < 0.0001) were observed. Thus, antihyperthermic treatment within the first 24 h was associated with both a better outcome and higher survival. An increased risk of developing m-MCA was associated with leukoaraiosis and an elevated level of microalbuminuria.
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spelling pubmed-91464282022-05-29 Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery Alonso-Alonso, Maria Luz Sampedro-Viana, Ana Rodríguez-Yáñez, Manuel López-Dequidt, Iria Pumar, José M. Mosqueira, Antonio J. Ouro, Alberto Ávila-Gómez, Paulo Sobrino, Tomás Campos, Francisco Castillo, José Hervella, Pablo Iglesias-Rey, Ramón J Clin Med Article Malignant infarction of the middle cerebral artery (m-MCA) is a complication of ischemic stroke. Since hyperthermia is a predictor of poor outcome, and antihyperthermic treatment is well tolerated, our main aim was to analyze whether the systemic temperature decrease within the first 24 h was associated with a better outcome. Furthermore, we studied potential biochemical and neuroimaging biomarkers. This is a retrospective observational analysis that included 119 patients. The temperature variations within the first 24 h were recorded. Biochemical laboratory parameters and neuroimaging variables were also analyzed. The temperature increase at the first 24 h (OR: 158.97; CI 95%: 7.29–3465.61; p < 0.001) was independently associated with a higher mortality. Moreover, antihyperthermic treatment (OR: 0.08; CI 95%: 0.02–0.38; p = 0.002) was significantly associated with a good outcome at 3 months. Importantly, antihyperthermic treatment was associated with higher survival at 3 months (78% vs. 50%, p = 0.003). Significant independently associations between the development of m-MCA and both microalbuminuria (OR: 1.01; CI 95%: 1.00–1.02; p = 0.005) and leukoaraiosis (OR: 3.07; CI 1.84–5.13–1.02; p < 0.0001) were observed. Thus, antihyperthermic treatment within the first 24 h was associated with both a better outcome and higher survival. An increased risk of developing m-MCA was associated with leukoaraiosis and an elevated level of microalbuminuria. MDPI 2022-05-19 /pmc/articles/PMC9146428/ /pubmed/35629002 http://dx.doi.org/10.3390/jcm11102874 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alonso-Alonso, Maria Luz
Sampedro-Viana, Ana
Rodríguez-Yáñez, Manuel
López-Dequidt, Iria
Pumar, José M.
Mosqueira, Antonio J.
Ouro, Alberto
Ávila-Gómez, Paulo
Sobrino, Tomás
Campos, Francisco
Castillo, José
Hervella, Pablo
Iglesias-Rey, Ramón
Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery
title Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery
title_full Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery
title_fullStr Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery
title_full_unstemmed Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery
title_short Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery
title_sort antihyperthermic treatment in the management of malignant infarction of the middle cerebral artery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146428/
https://www.ncbi.nlm.nih.gov/pubmed/35629002
http://dx.doi.org/10.3390/jcm11102874
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