Albumin therapy in acute stroke patients

Preclinical studies have recently shown that albumin has neuroprotective effects for stroke in animal models. Thus, we sought to evaluate the effects of albumin therapy in patients with acute cerebral infarcts. We prospectively studied 49 patients with moderate-to-severe cerebral infarcts within the middle cerebral arterial territory into one of two groups: the control group (N = 18) received saline, whereas the albumin group (N = 31) received either 40 g or 80 g of albumin within 24 h from symptom onset. The modified National Institutes of Health Stroke Scale (mNIHSS) and diffusion-weighted imaging (DWI) were serially checked. There was no adverse effect related to albumin therapy. Although there was no significant difference in both baseline mNIHSS score and DWI lesion volume on admission, the mNIHSS scores at the 14(th) day after treatment and the increase in DWI lesion volume 72-96 h after treatment were significantly reduced in patients of the albumin group (p = 0.001 and 0.012, respectively); these effects were dose- and time- related. The outcome on the 90(th) day after stroke onset was more favorable in the albumin group than in the control group. Within the albumin group, patients who had patent or recanalized vessels showed more significant improvement than patient without recanalization (p = 0.046). Our results indicate that albumin therapy is a safe and effective modality in patients with acute cerebral infarction. This study also suggests that the effects of albumin therapy may vary depending on vessel status of the patient.