Fluorescent Molecular Peroxidation Products: A Prognostic Biomarker of Early Neurologic Deterioration After Thrombolysis

Fluorescent molecular peroxidation products (FMPPs) are considered potential markers of molecular oxidative damage and may provoke increased permeability and disruption of the blood-brain barrier. This study aimed to determine the value of FMPPs as a biomarker to predict neurological worsening relat...

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Veröffentlicht in:Stroke (1970) 2014-02, Vol.45 (2), p.432-437
Hauptverfasser: LLOMBART, Víctor, DOMINGUEZ, Carmen, RIBO, Marc, ESCHENFELDER, Christoph, GIRALT, Dolors, MOLINA, Carlos A, ALVAREZ-SABIN, José, ROSELL, Anna, MONTANER, Joan, BUSTAMANTE, Alejandro, RODRIGUEZ-SUREDA, Victor, MARTIN-GALLAN, Pilar, VILCHES, Angel, GARCIA-BERROCOSO, Teresa, PENALBA, Anna, HERNANDEZ-GUILLAMON, Mar, RUBIERA, Marta
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container_end_page 437
container_issue 2
container_start_page 432
container_title Stroke (1970)
container_volume 45
creator LLOMBART, Víctor
DOMINGUEZ, Carmen
RIBO, Marc
ESCHENFELDER, Christoph
GIRALT, Dolors
MOLINA, Carlos A
ALVAREZ-SABIN, José
ROSELL, Anna
MONTANER, Joan
BUSTAMANTE, Alejandro
RODRIGUEZ-SUREDA, Victor
MARTIN-GALLAN, Pilar
VILCHES, Angel
GARCIA-BERROCOSO, Teresa
PENALBA, Anna
HERNANDEZ-GUILLAMON, Mar
RUBIERA, Marta
description Fluorescent molecular peroxidation products (FMPPs) are considered potential markers of molecular oxidative damage and may provoke increased permeability and disruption of the blood-brain barrier. This study aimed to determine the value of FMPPs as a biomarker to predict neurological worsening related to early hemorrhagic transformation. Baseline FMPP levels were measured in 186 consecutive acute ischemic stroke patients before tissue plasminogen activator treatment was administered. A serial FMPP profile (baseline before tissue plasminogen activator treatment, and 1, 2, 12, and 24 hours from treatment) was determined in a subset of 100 patients. Computed tomographic scans were performed at admission and repeated at 24 to 48 hours or after neurological worsening occurred. Symptomatic intracranial hemorrhage was defined as blood at any site in the brain associated with neurological deterioration. Patients who worsened had higher median FMPP levels compared with those who did not (59.68 [48.63-85.73] versus 44.87 [36.37-58.90] Uf/mL; P=0.035) at baseline. After logistic regression multivariate analysis, FMPP >48.2 Uf/mL together with age, hypertension, and systolic blood pressure remained baseline predictors of worsening at 48 hours. Moreover, baseline FMPP determination helped to distinguish between patients who worsened and those who did not (Integrated Discrimination Improvement index, 5.7%; P=0.0004). Finally, within patients who had worsened at 48 hours, those with symptomatic intracranial hemorrhage had higher FMPP levels (P=0.038). FMPPs might be a valuable biomarker of poor early neurological outcome and be related to the appearance of symptomatic intracranial hemorrhage in tissue plasminogen activator-treated patients, one of the most feared neurological complications after thrombolytic treatment of acute ischemic stroke.
doi_str_mv 10.1161/STROKEAHA.113.003431
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This study aimed to determine the value of FMPPs as a biomarker to predict neurological worsening related to early hemorrhagic transformation. Baseline FMPP levels were measured in 186 consecutive acute ischemic stroke patients before tissue plasminogen activator treatment was administered. A serial FMPP profile (baseline before tissue plasminogen activator treatment, and 1, 2, 12, and 24 hours from treatment) was determined in a subset of 100 patients. Computed tomographic scans were performed at admission and repeated at 24 to 48 hours or after neurological worsening occurred. Symptomatic intracranial hemorrhage was defined as blood at any site in the brain associated with neurological deterioration. Patients who worsened had higher median FMPP levels compared with those who did not (59.68 [48.63-85.73] versus 44.87 [36.37-58.90] Uf/mL; P=0.035) at baseline. After logistic regression multivariate analysis, FMPP &gt;48.2 Uf/mL together with age, hypertension, and systolic blood pressure remained baseline predictors of worsening at 48 hours. Moreover, baseline FMPP determination helped to distinguish between patients who worsened and those who did not (Integrated Discrimination Improvement index, 5.7%; P=0.0004). Finally, within patients who had worsened at 48 hours, those with symptomatic intracranial hemorrhage had higher FMPP levels (P=0.038). 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Drug treatments ; Prognosis ; Stroke - complications ; Stroke - drug therapy ; Thrombolytic Therapy - adverse effects ; Tissue Plasminogen Activator - adverse effects ; Tissue Plasminogen Activator - therapeutic use ; Tomography, X-Ray Computed ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2014-02, Vol.45 (2), p.432-437</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c286t-5fcc4e40b6a39cb2f6e3a07ec669375f07f7a5ce4c26a77a5ffd268fd24732603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=28195864$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24335228$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LLOMBART, Víctor</creatorcontrib><creatorcontrib>DOMINGUEZ, Carmen</creatorcontrib><creatorcontrib>RIBO, Marc</creatorcontrib><creatorcontrib>ESCHENFELDER, Christoph</creatorcontrib><creatorcontrib>GIRALT, Dolors</creatorcontrib><creatorcontrib>MOLINA, Carlos A</creatorcontrib><creatorcontrib>ALVAREZ-SABIN, José</creatorcontrib><creatorcontrib>ROSELL, Anna</creatorcontrib><creatorcontrib>MONTANER, Joan</creatorcontrib><creatorcontrib>BUSTAMANTE, Alejandro</creatorcontrib><creatorcontrib>RODRIGUEZ-SUREDA, Victor</creatorcontrib><creatorcontrib>MARTIN-GALLAN, Pilar</creatorcontrib><creatorcontrib>VILCHES, Angel</creatorcontrib><creatorcontrib>GARCIA-BERROCOSO, Teresa</creatorcontrib><creatorcontrib>PENALBA, Anna</creatorcontrib><creatorcontrib>HERNANDEZ-GUILLAMON, Mar</creatorcontrib><creatorcontrib>RUBIERA, Marta</creatorcontrib><title>Fluorescent Molecular Peroxidation Products: A Prognostic Biomarker of Early Neurologic Deterioration After Thrombolysis</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Fluorescent molecular peroxidation products (FMPPs) are considered potential markers of molecular oxidative damage and may provoke increased permeability and disruption of the blood-brain barrier. 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source MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Aged
Analysis of Variance
Biological and medical sciences
Biomarkers - blood
Blood. Blood coagulation. Reticuloendothelial system
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - epidemiology
Cerebral Hemorrhage - etiology
Disease Progression
Endpoint Determination
Female
Fibrinolytic Agents - adverse effects
Fibrinolytic Agents - therapeutic use
Fluorescence
Humans
Male
Medical sciences
Nervous System Diseases - etiology
Neurology
Oxidative Stress
Peroxides - blood
Pharmacology. Drug treatments
Prognosis
Stroke - complications
Stroke - drug therapy
Thrombolytic Therapy - adverse effects
Tissue Plasminogen Activator - adverse effects
Tissue Plasminogen Activator - therapeutic use
Tomography, X-Ray Computed
Vascular diseases and vascular malformations of the nervous system
title Fluorescent Molecular Peroxidation Products: A Prognostic Biomarker of Early Neurologic Deterioration After Thrombolysis
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