20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction

Abstract Background Early identification of massive middle cerebral artery infarction (MCAI) at risk for malignant MCAI (m-MCAI) may be useful in selecting patients for aggressive therapies. The aim of this study was to determine whether CYP metabolites may help to predict impending m-MCAI. Methods...

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Autores principales:	Xingyang Yi, Qiang Zhou, Ting Qing, Bing Ming, Jing Lin, Jie Li, Jie Lin
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	20-hydroxyeicosatetraenoic acid Brain edema Malignant middle cerebral artery infarction Massive middle cerebral artery infarction Prognosis Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/74c14932f8ae4ec483c4d12d950eee2c
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spelling	oai:doaj.org-article:74c14932f8ae4ec483c4d12d950eee2c2021-11-14T12:13:31Z20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction10.1186/s12883-021-02456-61471-2377https://doaj.org/article/74c14932f8ae4ec483c4d12d950eee2c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02456-6https://doaj.org/toc/1471-2377Abstract Background Early identification of massive middle cerebral artery infarction (MCAI) at risk for malignant MCAI (m-MCAI) may be useful in selecting patients for aggressive therapies. The aim of this study was to determine whether CYP metabolites may help to predict impending m-MCAI. Methods This is a prospective, two-center observational study in 256 patients with acute massive MCAI. Plasma levels of 20-hydroxyeicosatetraenoic acid (20-HETE), epoxyeicosatrienoic acids, and dihydroxyeicosatrienoic acids were measured at admission. Brain computed tomography (CT) was performed at admission and repeated between day 3 and 7, or earlier if there was neurological deterioration. The primary outcome was m-MCAI. The m-MCAI was diagnosed when follow-up brain CT detected a more than two-thirds space-occupying MCAI with midline shift, compression of the basal cisterns, and neurological worsening. Results In total of 256 enrolled patients, 77 (30.1%) patients developed m-MCAI. Among the 77 patients with m-MCAI, 60 (77.9%) patients died during 3 months of stroke onset. 20-HETE level on admission was significantly higher in patients with m-MCAI than those without m-MCAI. There was an increase in the risk of m-MCAI with increase of 20-HETE levels. The third and fourth quartiles of 20-HETE levels were independent predictors of m-MCAI (OR: 2.86; 95% CI: 1.16 – 6.68; P = 0.025, and OR: 4.23; 95% CI: 1.35 – 8.26; P = 0.002, respectively). Conclusions Incidence of m-MCAI was high in patients with massive MCAI and the prognosis of m-MCAI is very poor. Elevated plasma 20-HETE may be as a predictor for m-MCAI in acute massive MCAI, and it might useful in clinical practice in therapeutic decision making.Xingyang YiQiang ZhouTing QingBing MingJing LinJie LiJie LinBMCarticle20-hydroxyeicosatetraenoic acidBrain edemaMalignant middle cerebral artery infarctionMassive middle cerebral artery infarctionPrognosisNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	20-hydroxyeicosatetraenoic acid Brain edema Malignant middle cerebral artery infarction Massive middle cerebral artery infarction Prognosis Neurology. Diseases of the nervous system RC346-429
spellingShingle	20-hydroxyeicosatetraenoic acid Brain edema Malignant middle cerebral artery infarction Massive middle cerebral artery infarction Prognosis Neurology. Diseases of the nervous system RC346-429 Xingyang Yi Qiang Zhou Ting Qing Bing Ming Jing Lin Jie Li Jie Lin 20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
description	Abstract Background Early identification of massive middle cerebral artery infarction (MCAI) at risk for malignant MCAI (m-MCAI) may be useful in selecting patients for aggressive therapies. The aim of this study was to determine whether CYP metabolites may help to predict impending m-MCAI. Methods This is a prospective, two-center observational study in 256 patients with acute massive MCAI. Plasma levels of 20-hydroxyeicosatetraenoic acid (20-HETE), epoxyeicosatrienoic acids, and dihydroxyeicosatrienoic acids were measured at admission. Brain computed tomography (CT) was performed at admission and repeated between day 3 and 7, or earlier if there was neurological deterioration. The primary outcome was m-MCAI. The m-MCAI was diagnosed when follow-up brain CT detected a more than two-thirds space-occupying MCAI with midline shift, compression of the basal cisterns, and neurological worsening. Results In total of 256 enrolled patients, 77 (30.1%) patients developed m-MCAI. Among the 77 patients with m-MCAI, 60 (77.9%) patients died during 3 months of stroke onset. 20-HETE level on admission was significantly higher in patients with m-MCAI than those without m-MCAI. There was an increase in the risk of m-MCAI with increase of 20-HETE levels. The third and fourth quartiles of 20-HETE levels were independent predictors of m-MCAI (OR: 2.86; 95% CI: 1.16 – 6.68; P = 0.025, and OR: 4.23; 95% CI: 1.35 – 8.26; P = 0.002, respectively). Conclusions Incidence of m-MCAI was high in patients with massive MCAI and the prognosis of m-MCAI is very poor. Elevated plasma 20-HETE may be as a predictor for m-MCAI in acute massive MCAI, and it might useful in clinical practice in therapeutic decision making.
format	article
author	Xingyang Yi Qiang Zhou Ting Qing Bing Ming Jing Lin Jie Li Jie Lin
author_facet	Xingyang Yi Qiang Zhou Ting Qing Bing Ming Jing Lin Jie Li Jie Lin
author_sort	Xingyang Yi
title	20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
title_short	20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
title_full	20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
title_fullStr	20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
title_full_unstemmed	20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
title_sort	20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
publisher	BMC
publishDate	2021
url	https://doaj.org/article/74c14932f8ae4ec483c4d12d950eee2c
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20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction

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