Evaluation of Selenium Supplementation in Acute Ischemic Stroke Outcome: An Outcome Assessor Blind, Randomized,
Athena Sharifi-Razavi1, Narges Karimi1, Hamed Jafarpour1
1Clinical Research Development Unit of Bou-Ali Sina Hospital, Mazandarn University of Medical Science, Sari, Iran.
Background:
Selenium is a trace element that protects against cellular damage by oxygen radicals through selenoproteins. Ischemic stroke is associated with the generation of oxygen free radicals resulting in a condition of oxidative stress.
Objectives:
The present study aimed to evaluate the effect of selenium supplementation on short-term and long-term acute ischemic stroke outcomes.
Methods:
This was a randomized, parallel, outcome assessor blind, placebo-controlled feasibility study on ischemic stroke patients admitted in Bou-Ali Sina Hospital, Sari, Iran (2015-2017). Inclusion criteria were adults with accepted ischemic stroke by neuroimaging during the last 72h with a volume of at least one-third of MCA territory. The primary outcome was the short-term outcome measuring with the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) on day 7. The participants (44 patients) were randomized into two groups (22 in each group), one receiving intravenous selenium selenite for 5 days, and the other 40 cc normal saline as a placebo.
Results:
A total of 40 ischemic stroke patients (18 females, 22 males) with mean age of 68.2 ± 10 years were investigated. Selenium supplementation improved short-term outcome, 15.7% by using NIHSS (66% vs 42%, RR = 0.85 with CI = 0.54-1.35; NNT = 10; 95% CI = 5.15- 2.53, P = 0.51) and 46.3% by using mRS (57% vs 12%, RR = 0.52 with CI = 0.31-0.88; NNT = 3; 95% CI = 1.49 -7.59, P = 0.01). The long-term outcome did not change significantly by considering Barthel index >75 after 3 months in comparison to comparator group (33.3% vs 29.4%, RR = 1.13 with CI = 0.40-3.16; NNT = 26; 95% CI = 2.77 -3.54, P = 0.81].
Conclusions:
Selenium selenite supplementation in acute ischemic stroke can improve short-term outcome but cannot influence the long-term outcome.
