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Iron-related damage in acute ischemic stroke
A Dávalos1, J M Fernandez-Real, W Ricart
1Section of Neurology, Hospital Dr Josep Trueta, Girona, Spain.
Stroke
|August 1, 1994
Summary
High serum ferritin levels in acute ischemic stroke patients indicate a poor prognosis, independent of stress. This finding highlights iron stores as a potential prognostic marker in stroke care.
Area of Science:
- Neurology
- Biochemistry
- Clinical Medicine
Background:
- Iron-mediated mechanisms are implicated in experimental brain injury.
- The clinical significance of iron stores in acute ischemic stroke remains unclear.
Purpose of the Study:
- To investigate the relationship between iron stores, measured by serum ferritin, and the outcome of acute cerebral infarct.
- To determine if serum ferritin levels predict prognosis in acute ischemic stroke patients.
Main Methods:
- Sixty-seven patients with acute ischemic stroke (<24 hours) were assessed.
- Measurements included glycemia, glycosylated hemoglobin, cortisol, serum ferritin, and urinary cortisol.
- Patients were categorized by outcome (good vs. poor) using the Canadian Stroke Scale (CSS) at 30 days.
Main Results:
- Poor outcome was associated with higher fasting glycemia, serum cortisol, and urinary free cortisol.
- Serum ferritin levels were significantly higher in the poor outcome group (218 vs. 133 µg/L).
- Ferritin levels correlated with changes in CSS score, and were an independent predictor of poor outcome (OR 4.6).
Conclusions:
- Elevated serum ferritin within 24 hours of ischemic stroke admission is linked to a poor prognosis.
- This association is independent of the physiological stress response.
- Further research is required to understand the source and therapeutic implications of increased serum ferritin in stroke.