The utility of serum glucose potassium ratio as a predictive factor for haemorrhagic transformation, stroke recurrence, and mortality among ischemic stroke patients

Saudi Pharmaceutical Journal, Journal Year: 2024, Volume and Issue: 32(6), P. 102082 - 102082

Published: April 22, 2024

Glucose-Potassium Ratio (GPR) has emerged as a biomarker in several pathophysiological conditions. However, the association between GPR and long-term outcomes stroke patients not been investigated. Our study evaluated applicability of baseline predictive prognostic tool for clinical ischemic patients. The multicenter retrospective cohort included acute-subacute adult who had their serum levels measured. Eligible were categorized into two sub-cohorts based on (<1.67 vs. ≥ 1.67). primary outcome was incidence 30-day hemorrhagic transformation, while recurrence, all-cause mortality within twelve months, considered secondary. Among 4083 screened, 1047 current study. In comparison with < 1.67 group, significantly higher ratio months (aHR 2.07 [95 % CI 1.21–3.75] p = 0.01), transformation but failed to reach statistical significance 1.60 0.95–2.79], 0.08). Overall, is an independent predictor acute subacute stroke. Further studies are necessary validate these findings.

Language: Английский

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The Effects of Cannabinoids on Ischemic Stroke-Associated Neuroinflammation: A Systematic Review

Journal of Neuroimmune Pharmacology, Journal Year: 2025, Volume and Issue: 20(1)

Published: Feb. 3, 2025

Stroke represents a significant burden on global health and the economy, with high mortality rates, disability, recurrence. Ischemic stroke is serious condition that occurs when blood vessel in brain interrupted, reducing supply to affected area. Inflammation component pathophysiology. Neuroinflammation triggered following acute ischemic ictus, where blood–brain barrier (BBB) breaks down, causing damage endothelial cells. The will eventually generate oxidative stress, activate pathological phenotypes of astrocytes microglia, lead neuronal death neurovascular unit. As result, unleashes robust neuroinflammatory response, which can further worsen neurological outcomes. complex process involved repair. Finding new neuroinflammation molecular targets essential develop effective safe novel treatment approaches against stroke. Accumulating studies have investigated pharmacological properties cannabinoids (CBs) for many years, recent research has shown their potential therapeutic use treating rodent models. These findings revealed promising impacts CBs cellular ameliorating deficits. In this review, we explore possibility administration mitigating caused by We summarize results from several preclinical evaluating efficacy anti-inflammatory interventions Although convincing evidence implies targeting are stroke, translating these into clinical setting proven be challenging. translation hurdle due essence ability cause anxiety, cognitive deficit, psychosis. Future warranted address dose-beneficial effect trials stroke-related treatment.

Language: Английский

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A multicenter analysis to identify the risk factors for stroke recurrence and mortality within 1 year

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 5, 2025

Stroke recurrence is a serious and prevalent complication of ischemic stroke that warrants additional investigation. A hospital-based retrospective observational study included acute-subacute adult patients. The primary aim was to determine the risk factors associated with recurrent within 365 days. Additionally, combined outcome consisting any or all-cause mortality days considered secondary outcome. Univariate multivariable Cox proportional-hazards models were used examine association composite death/stroke recurrence. Of 1,244 patients, 112 (9%) experienced analysis identified for including history previous (HR = 3.65, 95% CI:2.28-5.99, p 0.0001), tissue plasminogen activator (tPA) treatment 2.84, CI:1.57-4.86, 0.0003), seizure 1.96, CI:1.14-3.22, 0.0105), depression 2.26, CI:1.33-3.69, 0.0016). Only 2.37, CI:1.74-3.26, 0.0001) remained significantly recurrence/death. Additional older age patients 1.02, CI:1.01-1.03, 0.0009), admission intensive care unit (ICU) 3.70, CI:2.63-5.22, pneumonia 1.47, CI:1.05-2.05, 0.0249), brain edema 2.36, CI:1.58-3.46, 0.0001). Key findings include rate 9.96% 21.83% Multivariable confirmed stroke, receiving tPA, experiencing seizures, Implementing preventive measures individuals in these high-risk categories essential. Further studies are needed validate our findings.

Language: Английский

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Assessing the effects of antidepressant use on stroke recurrence and related outcomes in ischemic stroke patients: a propensity score matched analysis

Frontiers in Pharmacology, Journal Year: 2025, Volume and Issue: 16

Published: March 12, 2025

The effect of antidepressant use, particularly that selective serotonin reuptake inhibitors, on stroke outcomes remains unclear. This hospital-based, retrospective, observational study utilized propensity score-matching (PSM) to assess the association between stroke-related outcomes, and complications. was conducted at King Abdulaziz Medical City (KAMC) in Jeddah Riyadh included 1,125 patients with acute-subacute ischemic stroke, whom 1,025 were non-users 100 users. After PSM, 200 (100 users non-users) final analysis. aimed recurrence, mortality. Additionally, examined use severity, functional independence, incidence post-stroke Kaplan-Meier analysis revealed no statistically significant differences recurrence ( p = 0.5619) or mortality 0.6433) over 1-year follow-up period. observed severity admission discharge 0.33210 0.78410, respectively) independence 0.9176 0.4383, two groups. These findings suggest does not significantly affect mortality, independence. However, further large-scale studies are warranted validate these investigate potential confounding factors, such as subtypes, co-use certain medications, physical activity.

Language: Английский

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Vitamin D and ischemic stroke - Association, mechanisms, and therapeutics

Ageing Research Reviews, Journal Year: 2024, Volume and Issue: 96, P. 102244 - 102244

Published: Feb. 21, 2024

Language: Английский

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Efficacy of Oral Supplementation with Cholecalciferol Versus Calcifediol in Patients with Hypovitaminosis D After Stroke

Nutrients, Journal Year: 2025, Volume and Issue: 17(6), P. 1035 - 1035

Published: March 15, 2025

Background/Objectives: Cholecalciferol and Calcifediol are commonly used for oral supplementation in patients with vitamin D deficiency. Several studies have compared these two molecules; however, the studied population has only included healthy postmenopausal women so far. This retrospective observational study aims to evaluate which molecule is more effective faster achieving serum 25(oh)D levels within normal range post-stroke during subacute phase. Secondary include assessing potential differences functional outcomes investigating possible correlation between degree of hypovitaminosis stroke severity. Methods: We observed 85 in-patients who received either or intensive rehabilitation. All subjects underwent evaluations, blood tests, a bone densitometry (DEXA) scan. Results: Four months after starting supplementation, receiving calcifediol achieved significantly higher (p < 0.001) those cholecalciferol. No significant between-group were secondary outcomes. Another key finding that no statistically was found Conclusions: These results highlight importance further metabolism patients, though findings should be confirmed larger studies.

Language: Английский

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Insights into risk factors and outcomes of post-stroke seizures in Saudi Arabia: a multicenter analysis

Metabolic Brain Disease, Journal Year: 2024, Volume and Issue: 40(1)

Published: Dec. 19, 2024

Post-stroke seizures present a global challenge, yet its frequency and factors associated with incidence are poorly documented, particularly in the Middle East. Thus, this study aims to investigate post-stroke seizure stroke-associated among ischemic stroke patients Saudi Arabia, addressing demographic, clinical, comorbid aspects improve prognosis, diagnosis, prevention, management. A multicenter, cohort observational included eligible who were categorized into those developed after injury did not. Additionally, assessed association between 12-month mortality, recurrence, occurrence of hemorrhagic transformation (HT) within 30 days. The involved 1235 patients, which 13.5% seizures. Patients had more extended hospital stays, higher intensive care unit (ICU) admission rates, prevalence comorbidities. Factors independently previous history (OR = 1.93; 1.35–2.75), ICU 1.7; 1.15–2.5), depression 2.1; 1.38–3.30). Logistic regression revealed associations HT 2.61; 1.70-4.00), recurrence 2.30; 1.58–3.36), mortality 1.89; 1.33–2.68). However, adjusting for covariates, significantly only (aOR 1.11–2.63). Our identifies notable risk patients. This underscores importance adopting comprehensive approach enhance prediction, management Further research is warranted validate these findings, understanding mechanisms, guide strategies.

Language: Английский

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Vitamin D supplementation in later life: a systematic review of efficacy and safety in movement disorders

Frontiers in Aging Neuroscience, Journal Year: 2024, Volume and Issue: 16

Published: Jan. 26, 2024

Introduction Nutrition plays a pivotal role in the multidisciplinary approach to rehabilitating middle old-aged patients with neurological diseases including movement disorders (MDs). Despite prevalence of vitamin D deficiency many MDs, data supporting supplementation’s effectiveness and safety is sparse conflicting, therefore, our explicit objective was provide an all-encompassing review subject. Methods A comprehensive search PubMed, Embase, other scientific databases conducted up November 1 2023. The searches included RCTs all languages human participants aged 35 above not meeting these requirements led exclusion. Results Four studies on Parkinson’s disease (PD) one restless legs syndrome (RLS) 369 MD patients, however, none rehabilitation context, were found. Although three four PD showed better outcomes, such as decreasing levodopa-induced dyskinesia or enhancing physical performance some domains, RLS study did identify symptom improvement. serious adverse effect observed, cerebral infarction, aroused concerns, however its relationship consumption questionable. Structurally can be characterized by large variations patient populations, primary severity, but typically relatively short duration therapy most cases. With limitations small number studies, major trial design heterogeneity, limited sample sizes, greatly variable Cochrane risk bias (RoB) evaluation, only qualitative synthesis feasible. Discussion Two main implications inferred from results, which we interpret cautiously promising overall insufficient for firm recommendations. First, there urgent need more research MDs middle- older-aged population, particularly during rehabilitation. Second, given benefits supplementation those who are deficient, recommend routine screening patients.

Language: Английский

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Lower 25-hydroxyvitamin D is associated with severer white matter hyperintensity and cognitive function in patients with non-disabling ischemic cerebrovascular events

Journal of Stroke and Cerebrovascular Diseases, Journal Year: 2023, Volume and Issue: 32(10), P. 107311 - 107311

Published: Aug. 31, 2023

This study aimed to investigate the potential correlations among serum 25-hydroxyvitamin D [25(OH)D] levels, white matter hyperintensity (WMH) and cognitive function in patients with non-disabling ischemic cerebrovascular events (NICE).This was a prospective investigation of 160 NICE age 40 years or older. Cognitive evaluated by Montreal Assessment (MoCA). White lesions were WMH using Fazekas scores. Spearman correlation analysis linear regression models used identify associations between 25(OH)D levels function. Binary logistic evaluate predictable value for impairment.Patients inadequate had lower MoCA score (P=0.008), higher proportion severe (P=0.043). demonstrated that concentrations positively associated (rs=0.185, P=0.019) while negatively related (sWMH) (rs=-0.166, P=0.036).The association remained significant (adjusted β=0.012, 95%CI:0.001-0.203).Adjusted binary showed odds ratio impairment insufficient concentration 5.038 (95%CI:1.154-21.988) compared sufficient group sWMH (OR=2.728, 95%CI:1.230-6.051) identified as an independent risk factor decline patients.Serum independently significantly patients.

Language: Английский

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Impact of Vitamin D Deficiency on Ischemic Stroke Severity: Insights from a Prospective Study

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 13, 2024

Background Ischemic stroke, characterized by the obstruction of blood flow to brain, is a major cause morbidity and mortality worldwide. The severity ischemic stroke commonly assessed using National Institutes Health Stroke Scale (NIHSS), which helps predict patient outcomes. Recent research suggests potential link between low vitamin D levels an increased risk cerebrovascular events, including stroke. However, specific relationship deficiency remains underexplored. Objectives study aimed investigate correlation serum NIHSS scores in patients with determine whether associated neurological deficits these patients. Materials methods This prospective observational was conducted at Saveetha Medical College, Chennai, involved 86 presenting acute Inclusion criteria were age ≥18 years, confirmed diagnosis neuroimaging, presentation within 24 hours symptom onset. Exclusion included hemorrhagic conditions affecting metabolism, current supplementation. Serum 25-hydroxyvitamin (25(OH)D) measured chemiluminescence immunoassay (CLIA), admission. Statistical analyses Pearson's multivariate linear regression adjust for confounding variables. Results found that lower 25(OH)D correlated higher symptoms, as indicated significant negative admission (Pearson coefficient r = -0.4081, p < 0.001). Multivariate analysis this association (β -0.3994, 0.001) after adjusting age, sex, comorbidities, 0.05 considered statistically significant. In addition, 0.1123, 0.009) comorbid 0.9565, 0.008) significantly scores. Conclusion demonstrates severity, suggesting may be less severe strokes. Further needed explore mechanistic pathways therapeutic management. Emphasizing importance maintaining adequate could crucial potentially reducing improving

Language: Английский

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