Catecholamines, infection, and death in acute ischemic stroke Export

@article{chamorro07catecholamines, abstract = {1: J Neurol Sci. 2007 Jan 15;252(1):29-35. Epub 2006 Nov 28. Links Catecholamines, infection, and death in acute ischemic stroke.Chamorro A, Amaro S, Vargas M, Obach V, Cervera A, G\'{o}mez-Choco M, Torres F, Planas AM. Stroke Unit, Hospital Cl\'{\i}nic and Institut d' Investigacions Biom\'{e}diques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain. achamorro@ub.edu Experimental studies have recently suggested that acute ischemia may facilitate the appearance of fatal infections as part of a brain-induced immunodepression syndrome. However, the mechanisms and neurological consequences of infections complicating acute ischemic stroke have received much less attention at the bedside. The incidence of infection and death after non-septic stroke was compared in this prospective study with longitudinal changes of cytokines, leukocytes, normetanephrine (NMN) and metanephrine (MN) in 75 consecutive patients. In multivariate analysis, infection, n = 13 (17\%), was associated with the upper quartile of MN (OR 3.51, 95\% CI 1.30-9.51), neurological impairment (NIHSS) on admission (OR 3.99, 95\% CI 1.34-11.8), monocyte count (OR 1.78, 95\% CI 1.13-2.79), and increased interleukin (IL)-10 (OR 1.54, 95\% CI 1.00-2.38). Mortality at 3 months, n = 16 (21\%), was associated with increased levels of NMN on admission (OR 2.34 95\% CI 1.15-4.76), NIHSS score (OR 2.57, 95\% CI 1.29-5.11), and higher IL-6 levels (OR 1.29, 95\% 1.00-1.67). These findings suggest that acute ischemic stroke is associated with an early activation of the sympathetic adrenomedullar pathway that lowers the threshold of infection and increases the risk of death. Moreover, these findings are independent of the blood borne effects of pro- and anti-inflammatory cytokines, and circulating leukocytes. PMID: 17129587 [PubMed - indexed for MEDLINE]}, author = {Chamorro and Amaro, S. and Vargas, M. and Obach, V. and Cervera and Choco, G\'{o}mez M. and Torres, F. and Planas, A. M.}, citeulike-article-id = {3496116}, journal = {Journal of the Neurological Sciences}, keywords = {catecholamine, nnm}, number = {1}, pages = {29--35}, posted-at = {2008-11-08 11:23:47}, priority = {2}, publisher = {Elsevier}, title = {Catecholamines, infection, and death in acute ischemic stroke}, volume = {252}, year = {2007} }

TY - JOUR ID - chamorro07catecholamines L3 - citeulike-article-id:3496116 N2 - 1: J Neurol Sci. 2007 Jan 15;252(1):29-35. Epub 2006 Nov 28. Links Catecholamines, infection, and death in acute ischemic stroke.Chamorro A, Amaro S, Vargas M, Obach V, Cervera A, Gómez-Choco M, Torres F, Planas AM. Stroke Unit, Hospital Clínic and Institut d' Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain. achamorro@ub.edu Experimental studies have recently suggested that acute ischemia may facilitate the appearance of fatal infections as part of a brain-induced immunodepression syndrome. However, the mechanisms and neurological consequences of infections complicating acute ischemic stroke have received much less attention at the bedside. The incidence of infection and death after non-septic stroke was compared in this prospective study with longitudinal changes of cytokines, leukocytes, normetanephrine (NMN) and metanephrine (MN) in 75 consecutive patients. In multivariate analysis, infection, n = 13 (17%), was associated with the upper quartile of MN (OR 3.51, 95% CI 1.30-9.51), neurological impairment (NIHSS) on admission (OR 3.99, 95% CI 1.34-11.8), monocyte count (OR 1.78, 95% CI 1.13-2.79), and increased interleukin (IL)-10 (OR 1.54, 95% CI 1.00-2.38). Mortality at 3 months, n = 16 (21%), was associated with increased levels of NMN on admission (OR 2.34 95% CI 1.15-4.76), NIHSS score (OR 2.57, 95% CI 1.29-5.11), and higher IL-6 levels (OR 1.29, 95% 1.00-1.67). These findings suggest that acute ischemic stroke is associated with an early activation of the sympathetic adrenomedullar pathway that lowers the threshold of infection and increases the risk of death. Moreover, these findings are independent of the blood borne effects of pro- and anti-inflammatory cytokines, and circulating leukocytes. PMID: 17129587 [PubMed - indexed for MEDLINE] IS - 1 JF - Journal of the Neurological Sciences EP - 35 TI - Catecholamines, infection, and death in acute ischemic stroke PB - Elsevier VL - 252 SP - 29 KW - catecholamine KW - nnm AU - Chamorro AU - Amaro, S AU - Vargas, M AU - Obach, V AU - Cervera AU - Choco, Gómez AU - Torres, F AU - Planas, AM PY - 2007/// ER -