Prognostic value of cerebrospinal fluid free fatty acid levels in patients with acute ischemic stroke

Wei, Xue-Jun; Han, Meng; Wei, Guangchen; Duan, Chonghao

doi:10.3389/fnhum.2015.00402

Cited by 8 publications

(7 citation statements)

References 33 publications

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“…Another point of view, our data were not in agreement with Wei et al [ 20 ] and Wang et al [ 19 ] who found a statistical correlation between cardioembolic (CE) stroke and FFA levels in CSF.…”

Section: Discussioncontrasting

confidence: 99%

“…In association with our results, Wei et al [ 20 ] and Duan et al [ 22 ] found that nonsurvivors had significantly higher FFA levels in CSF than survivors with increased risk of death.…”

Section: Discussionsupporting

confidence: 92%

“…This was in agreement with Wei et al [ 20 ] who studied 238 patients with AIS between 2012 and 2014; then, he found that elevated FFA levels in CSF were correlated with increasing severity of stroke after accounting for the NIHSS score.…”

Section: Discussionsupporting

confidence: 91%

“…Also, Wei et al [ 20 ] stated that the FFA level in CSF could be an independent predictive indicator for functional outcome up to 90 days after AIS.…”

Section: Discussionmentioning

confidence: 99%

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Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU

Gaber

ElGazzar

Qenawi

et al. 2020

Critical Care Research and Practice

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Introduction. Brain ischemia initiated significant increase in FFAs in animal studies. Accumulation of FFA can lead to liberation of inflammatory byproducts that contribute to neuronal death. Increased risk of systemic thromboembolism was seen in animal models after FFA infusion possibly through activation of factor XII by stearic acids. The clinical studies that examined the relation between stroke in humans and CSF biomarkers are infrequent. Aim of Work. We tried to evaluate the potential role of FFAs in CSF in the diagnosis and the prognosis of ICU patients with AIS while comparing the results to traditional neurological scoring systems. Patients and Methods. Our study included 80 patients who were admitted to ICU with acute ischemic stroke (AIS) within 24 hours of the onset of cerebral infarction. CSF samples were obtained at admission. The FFA levels were measured using the sensitive enzyme-based colorimetric method. The NIHSS, GCS, and mRS were evaluated at admission and at 30 days. Univariate and multivariate analysis were used to evaluate the stroke outcome according to FFA levels in CSF. Results. Worsening of the GCS (<7) at 30 days showed a significant correlation with FFA in CSF. The ROC curve showed a cutoff value of 0.27 nmol/µl, sensitivity of 62.9%, and specificity of 72.2%. There was a significant correlation between FFA in CSF and the mRS >2 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/µl, specificity of 69.2%, and sensitivity of 59.7%. There was a significant correlation between FFA in CSF and the NIHSS ≥ 16 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/µl, specificity of 72.2%, and sensitivity of 62.9%. Our study subdivided patients according to infarction volume and compared the 2 subgroups with FFA in CSF. We found a significant difference between 2 subgroups. FFA levels showed a positive correlation with infarction volume ≥145 ml. The ROC curve showed a cutoff value of 0.25 nmol/µl, sensitivity of 76.9%, and specificity of 71.4%. Our study showed that FFA in CSF was a significant predictor of all-cause mortality (0.37 + 0.26, P value 0.007). The ROC curve showed a cutoff value of 0.27, specificity of 72.2%, and sensitivity of 62.9%. There was a positive correlation between FFA in CSF and neurological causes of mortality (0.48 + 0.38, P value 0.037). The ROC curve showed a cutoff value of 0.37 nmol/µl, specificity of 76.1%, and sensitivity of 61.5%. Conclusion. FFA in CSF may serve as an independent prognostic biomarker for assessing the prognosis of acute ischemic stroke and the clinical outcome. It might be a useful biomarker for early detection of high-risk patients for poor outcome and hence more aggressive treatment.

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Section: Discussioncontrasting

confidence: 99%

“…In association with our results, Wei et al [ 20 ] and Duan et al [ 22 ] found that nonsurvivors had significantly higher FFA levels in CSF than survivors with increased risk of death.…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

“…Also, Wei et al [ 20 ] stated that the FFA level in CSF could be an independent predictive indicator for functional outcome up to 90 days after AIS.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU

Gaber

ElGazzar

Qenawi

et al. 2020

Critical Care Research and Practice

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“…Поскольку левокарнитин обладает мощными антиоксидантными эффектами, он оказывает и нейропротективное действие, обнаруженное в исследованиях in vitro, в экспериментах на животных. Так, выявлена прямая корреляция между концентрацией свободных жирных кислот в спинномозговой жидкости и вероятностью развития ишемического инсульта, особенно кардиоэмболического подтипа [44].…”

Section: дисциркуляторная энцефалопатия ишемический инсультunclassified

Levocarnitine for the Treatment of Polymorbid Patients

Переверзев

Shevchenko

Filippova

et al. 2020

Racionalʹnaâ farmakoterapiâ v kardiologii

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Effective and safe treatment of patients with polymorbidity is an urgent task of modern healthcare. Of particular difficulty is the treatment of patients with cardiovascular comorbidity, which requires an integrated approach to the treatment and development of a special, so-called patient-oriented approach. Modern scientific evidence proposes the use of levocarnitine, as part of complex therapy to increase its effectiveness. So, it was shown that levocarnitine can have a beneficial effect on blood pressure in patients with hypertension, especially those who are overweight and obese. Levocarnitine is also effective in the treatment of heart failure, which has been studied in several clinical studies, which demonstrated its ability to increase the ejection fraction of the left ventricle, stroke volume of blood and other indicators. Optimization of the bioavailability of nitrogen oxide (NO) and a decrease in systemic oxidative stress while taking levocarnitine plays an important positive role in complex therapy in patients with coronary artery disease: exertional angina and post-infarction cardiosclerosis, reducing the number of anginal attacks. Since levocarnitine has powerful antioxidant effects, it also has the neuroprotective effect found in in vitro studies in animal experiments. In case of impaired renal function, due to accelerated elimination and impaired reabsorption, a deficiency of levocarnitine in the body tissues develops, and therefore the US Food and Drug Administration (US FDA) decided on the possibility of using levocarnitine in patients on hemodialysis. Thus, taking into account the positive effects of levocarnitine in a number of frequently combined diseases, it can be considered as the drug of choice in the treatment of patients with polymorbidity.

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Cerebrospinal fluid levels of free fatty acid associated with ischemic stroke recurrence and functional outcome

2016

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The aim of this study was to evaluate the association between cerebrospinal fluid (CSF) levels of free fatty acid (FFA) and functional outcome and stroke recurrence in patients with ischemic stroke. In a prospective study, CSF levels of FFA were measured using an enzyme cycling method on admission in 217 consecutive patients with first-ever ischemic stroke. Clinical information was collected. Functional outcome and stroke recurrence were evaluated at 1-year follow-up. Multivariate analyses were performed using logistic regression models. The CSF FFA level was obtained in all patients with a median value of 0.22 (IQR 0.12-0.33) mmol/l. At admission, 89 patients (41.0 %) had a minor stroke (NIHSS < 5). In these patients, the median FFA level was lower than that observed in patients with moderate-to-high clinical severity (0.16 vs 0.27 mmol/l, p < 0.001). Patients with unfavorable outcomes and stroke recurrence had significantly higher FFA CSF levels on admission (all p < 0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that CSF FFA ≥ 0.33 mmol/l (third quarters) was an independent predictor of functional outcome (OR = 2.825; 95 % CI 1.502-5.313, p = 0.001) and stroke recurrence (OR = 7.862; 95 % CI 3.248-19.031, p < 0.0001). Our results demonstrate that high FFA SCF levels were independently associated with both the poor functional prognosis and stroke recurrence in patients with ischemic stroke.

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Prognostic value of cerebrospinal fluid free fatty acid levels in patients with acute ischemic stroke

Cited by 8 publications

References 33 publications

Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU

Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU

Levocarnitine for the Treatment of Polymorbid Patients

Cerebrospinal fluid levels of free fatty acid associated with ischemic stroke recurrence and functional outcome

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