İsmail Atik1, Nalan Kozacı2, İnan Beydilli3, Mustafa Avcı4, Hamit Ellidağ5, Mustafa Keşaplı6. 1. Department of Emergency Medicine, Ümraniye Education and Research Hospital, İstanbul, Turkey. Electronic address: doktoratik@hotmail.com. 2. Department of Emergency Medicine, Antalya Education and Research Hospital, Antalya, Turkey. Electronic address: nalankozaci@gmail.com. 3. Department of Emergency Medicine, Antalya Education and Research Hospital, Antalya, Turkey. Electronic address: inan_beydilli@hotmail.com. 4. Department of Emergency Medicine, Antalya Education and Research Hospital, Antalya, Turkey. Electronic address: dravcimustafa@gmail.com. 5. Department of Biochemistry Medicine, Antalya Education and Research Hospital, Antalya, Turkey. Electronic address: hayael1980@hotmail.com. 6. Department of Emergency Medicine, Antalya Education and Research Hospital, Antalya, Turkey. Electronic address: mustafakesapli@hotmail.com.
Abstract
OBJECTIVE: In this study, we aimed to identify oxidative stress and the disruption in the oxidant-antioxidant balance in the acute phase of stroke and, therefore, to detect markers that will guide in the diagnosis and treatment of stroke. MATERIALS AND METHODS: Eighty-six patients who were admitted to Antalya Training and Research Hospital Emergency Department between June 2013 and December 2013 and who were diagnosed as having stroke were enrolled in this study. The control group consisted of 40 healthy volunteers. Blood samples collected from all participants were screened for albumin, ischemic modified albumin (IMA), IMA/albumin ratio (IMAR), total antioxidant status, total oxidant status (TOS), and oxidative stress index (OSI). RESULTS: Sixty (70%) patients were diagnosed as having acute cerebral infarction (ACI) and 26 (30%) as having acute intracerebral hemorrhage (AIH). Statistically significant difference was found between AIH and control groups in terms of albumin, IMAR, TOS, OSI levels (P < .001, P < .001, P < .001, and P < .001, respectively). Statistically significant difference was found between ACI and control groups in terms of albumin, IMA, IMAR, TOS, and OSI levels (P < .001, P = .045, P < .001, P < .001, and P < .001, respectively). There was no difference between ACI patients with detected acute infarcts on cranial computed tomographic scans (n = 31) and ACI patients with normal cranial computed tomography results (n = 29) in terms of oxidant-antioxidant levels. There was a significant difference between patients admitted within 3 hours and healthy adults regarding the levels of IMAR, TOS, and OSI (P < .001, P < .001, and P < .001, respectively). DISCUSSION AND CONCLUSION: It was seen that oxidant-antioxidant balance was impaired in favor of oxidants in ACI and AIH. In addition, impairment in oxidant-antioxidant balance was found in the early stages of ACI. Therefore, these biomarkers can be used especially in the early diagnosis of thrombolytic therapy candidates in ACI.
OBJECTIVE: In this study, we aimed to identify oxidative stress and the disruption in the oxidant-antioxidant balance in the acute phase of stroke and, therefore, to detect markers that will guide in the diagnosis and treatment of stroke. MATERIALS AND METHODS: Eighty-six patients who were admitted to Antalya Training and Research Hospital Emergency Department between June 2013 and December 2013 and who were diagnosed as having stroke were enrolled in this study. The control group consisted of 40 healthy volunteers. Blood samples collected from all participants were screened for albumin, ischemic modified albumin (IMA), IMA/albumin ratio (IMAR), total antioxidant status, total oxidant status (TOS), and oxidative stress index (OSI). RESULTS: Sixty (70%) patients were diagnosed as having acute cerebral infarction (ACI) and 26 (30%) as having acute intracerebral hemorrhage (AIH). Statistically significant difference was found between AIH and control groups in terms of albumin, IMAR, TOS, OSI levels (P < .001, P < .001, P < .001, and P < .001, respectively). Statistically significant difference was found between ACI and control groups in terms of albumin, IMA, IMAR, TOS, and OSI levels (P < .001, P = .045, P < .001, P < .001, and P < .001, respectively). There was no difference between ACI patients with detected acute infarcts on cranial computed tomographic scans (n = 31) and ACI patients with normal cranial computed tomography results (n = 29) in terms of oxidant-antioxidant levels. There was a significant difference between patients admitted within 3 hours and healthy adults regarding the levels of IMAR, TOS, and OSI (P < .001, P < .001, and P < .001, respectively). DISCUSSION AND CONCLUSION: It was seen that oxidant-antioxidant balance was impaired in favor of oxidants in ACI and AIH. In addition, impairment in oxidant-antioxidant balance was found in the early stages of ACI. Therefore, these biomarkers can be used especially in the early diagnosis of thrombolytic therapy candidates in ACI.