RESULTS: Plasma polyamine levels were measured at admission in 3570 patients with acute ischemic stroke, and clinical outcomes were assessed at 3 months after stroke onset. The primary outcome was a composite outcome of death and major disability (modified Rankin Scale score≥3), and secondary outcomes included the individual outcomes of death and major disability. During a 3-month follow-up period, 877 participants (25.1%) experienced the primary outcome. Increased putrescines were associated with a decreased risk of the primary outcome (the highest versus the lowest tertile: odds ratio, 0.72 [95% CI, 0.58-0.91]; P=0.005) and major disability (odds ratio, 0.59 [95% CI, 0.47-0.74]; P<0.001). Conversely, increased spermidines were associated with an increased risk of death (hazard ratio, 1.86 [95% CI, 1.10-3.14]; P=0.020), and increased spermines were associated with an increased risk of the primary outcome (odds ratio, 1.36 [95% CI, 1.08-1.71]; P=0.009) and major disability (odds ratio, 1.27 [95% CI, 1.01-1.59]; P=0.041).
CONCLUSIONS: Among patients with ischemic stroke, high plasma putrescine levels were associated with a decreased risk of adverse outcomes, whereas high plasma spermidine and spermine levels were associated with an increased risk of adverse outcomes. Further studies are needed to investigate whether targeting these polyamines can improve the prognosis of patients with ischemic stroke.
BACKGROUND: https://clinicaltrials.gov. Identifier: NCT01840072.
结果:在3570例急性缺血性卒中患者入院时测量血浆多胺水平,在卒中发病后3个月评估临床结局.主要结局是死亡和严重残疾的复合结局(改良的Rankin量表评分≥3),次要结局包括死亡和重大残疾的个体结局.在3个月的随访期间,877名参与者(25.1%)经历了主要结果。腐胺的增加与主要结局的风险降低相关(最高与最低的三元:比值比,0.72[95%CI,0.58-0.91];P=0.005)和重大残疾(赔率比,0.59[95%CI,0.47-0.74];P<0.001)。相反,亚精胺增加与死亡风险增加相关(风险比,1.86[95%CI,1.10-3.14];P=0.020),精胺的增加与主要结局的风险增加相关(比值比,1.36[95%CI,1.08-1.71];P=0.009)和重大残疾(赔率比,1.27[95%CI,1.01-1.59];P=0.041)。
结论:在缺血性卒中患者中,高血浆腐胺水平与不良结局风险降低相关,而高血浆亚精胺和精胺水平与不良结局风险增加相关.需要进一步的研究来研究靶向这些多胺是否可以改善缺血性卒中患者的预后。
背景:https://clinicaltrials.gov.标识符:NCT01840072。