Anya Turetsky1, Richard P Goddeau1, Nils Henninger2. 1. Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts. 2. Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: nils.henninger@umassmed.edu.
Abstract
BACKGROUND: Despite its high prevalence, known association with vascular disease and stroke incidence and fatality, little is known about the contribution of vitamin D status to a worse outcome after ischemic stroke. Therefore, we sought to assess whether low serum 25-hydroxyvitamin D (25[OH]D), a marker of vitamin D status, is predictive of the ischemic infarct volume and whether it relates to a worse outcome. METHODS: We retrospectively analyzed prospective, consecutive acute ischemic stroke patients evaluated from January 2013 to January 2014 at a tertiary referral center. All patients (n = 96) had a magnetic resonance imaging-proven acute ischemic stroke. Multivariable linear and logistic regression analyses were used to test whether vitamin D represents an independent predictor of infarct volume and poor 90-day outcome (modified Rankin Scale score of >2). RESULTS: In univariable analyses, lacunar infarct etiology, lower admission National Institutes of Health Stroke Scale, and higher serum 25(OH)D concentration were associated with smaller infarct volumes (P < .05). The association of 25(OH)D with ischemic infarct volume was independent of other known predictors of the infarct extent (P = .001). Multivariable analyses showed that the risk for a poor 90-day outcome doubled with each 10-ng/mL decrease in serum 25(OH)D. CONCLUSIONS: Low serum 25(OH)D was independently associated with larger ischemic infarct volume, which may partially explain observed worse outcomes in ischemic stroke patients with poor vitamin D status. Although causality remains to be proven, our results provide the rationale to further explore vitamin D as a promising marker for cerebral ischemic vulnerability and to identify stroke patients at high risk for poor outcome.
BACKGROUND: Despite its high prevalence, known association with vascular disease and stroke incidence and fatality, little is known about the contribution of vitamin D status to a worse outcome after ischemic stroke. Therefore, we sought to assess whether low serum 25-hydroxyvitamin D (25[OH]D), a marker of vitamin D status, is predictive of the ischemic infarct volume and whether it relates to a worse outcome. METHODS: We retrospectively analyzed prospective, consecutive acute ischemic strokepatients evaluated from January 2013 to January 2014 at a tertiary referral center. All patients (n = 96) had a magnetic resonance imaging-proven acute ischemic stroke. Multivariable linear and logistic regression analyses were used to test whether vitamin D represents an independent predictor of infarct volume and poor 90-day outcome (modified Rankin Scale score of >2). RESULTS: In univariable analyses, lacunar infarct etiology, lower admission National Institutes of Health Stroke Scale, and higher serum 25(OH)D concentration were associated with smaller infarct volumes (P < .05). The association of 25(OH)D with ischemic infarct volume was independent of other known predictors of the infarct extent (P = .001). Multivariable analyses showed that the risk for a poor 90-day outcome doubled with each 10-ng/mL decrease in serum 25(OH)D. CONCLUSIONS: Low serum 25(OH)D was independently associated with larger ischemic infarct volume, which may partially explain observed worse outcomes in ischemic strokepatients with poor vitamin D status. Although causality remains to be proven, our results provide the rationale to further explore vitamin D as a promising marker for cerebral ischemic vulnerability and to identify strokepatients at high risk for poor outcome.
Authors: Megan A Evans; Hyun Ah Kim; T Michael De Silva; Thiruma V Arumugam; Andrew N Clarkson; Grant R Drummond; Graeme R Zosky; Brad Rs Broughton; Christopher G Sobey Journal: J Cereb Blood Flow Metab Date: 2017-08-23 Impact factor: 6.200
Authors: J S McNally; T M Burton; B W Aldred; S-E Kim; M S McLaughlin; L B Eisenmenger; G J Stoddard; J J Majersik; D V Miller; G S Treiman; D L Parker Journal: AJNR Am J Neuroradiol Date: 2016-06-16 Impact factor: 3.825
Authors: Thomas J Littlejohns; Katarina Kos; William E Henley; Iain A Lang; Cedric Annweiler; Olivier Beauchet; Paulo H M Chaves; Bryan R Kestenbaum; Lewis H Kuller; Kenneth M Langa; Oscar L Lopez; David J Llewellyn Journal: PLoS One Date: 2016-05-11 Impact factor: 3.240