Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases Suzhou Medical College of Soochow University Suzhou China.
Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA USA.
J Am Heart Assoc. 2024 Aug 6;13(15):e035837. doi: 10.1161/JAHA.124.035837. Epub 2024 Jul 31.
Polyamines have been reported to be associated with neurological function, but the associations between polyamines and the prognosis of ischemic stroke remain unclear. We aimed to prospectively investigate whether elevated plasma polyamine levels are associated with adverse outcomes in patients with ischemic stroke.
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]; =0.005) and major disability (odds ratio, 0.59 [95% CI, 0.47-0.74]; <0.001). Conversely, increased spermidines were associated with an increased risk of death (hazard ratio, 1.86 [95% CI, 1.10-3.14]; =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]; =0.009) and major disability (odds ratio, 1.27 [95% CI, 1.01-1.59]; =0.041).
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.
https://clinicaltrials.gov. Identifier: NCT01840072.
多胺已被报道与神经功能有关，但多胺与缺血性脑卒中预后之间的关系尚不清楚。我们旨在前瞻性研究急性缺血性脑卒中患者入院时血浆多胺水平升高是否与不良预后相关。
在 3570 例急性缺血性脑卒中患者入院时测量了血浆多胺水平，并在脑卒中发病后 3 个月评估了临床结局。主要结局是死亡和主要残疾（改良 Rankin 量表评分≥3）的复合结局，次要结局包括死亡和主要残疾的单个结局。在 3 个月的随访期间，877 名参与者（25.1%）发生了主要结局。尸胺水平升高与主要结局风险降低相关（最高与最低三分位数：比值比，0.72[95%CI，0.58-0.91]；=0.005）和主要残疾（比值比，0.59[95%CI，0.47-0.74]；<0.001）。相反，精脒水平升高与死亡风险增加相关（风险比，1.86[95%CI，1.10-3.14]；=0.020），精胺水平升高与主要结局风险增加相关（比值比，1.36[95%CI，1.08-1.71]；=0.009）和主要残疾（比值比，1.27[95%CI，1.01-1.59]；=0.041）。
在缺血性脑卒中患者中，高血浆尸胺水平与不良结局风险降低相关，而高血浆精脒和精胺水平与不良结局风险增加相关。需要进一步研究以确定是否可以针对这些多胺来改善缺血性脑卒中患者的预后。
