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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...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9146428 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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