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(Stroke. 2000;31:720.)
© 2000 American Heart Association, Inc.
Original Contributions |
Plasma Endothelin-1 Levels Neither Increase nor Correlate With Neurological Scores, Stroke Risk Factors, or Outcome in Patients With Ischemic Stroke
From the Department of Neurology (E.H., T.T., L.S., M.K.), Helsinki University Central Hospital, Helsinki, Finland; and Abbott Laboratories (K.H., C.L., T.J.O.), Abbott Park, Ill.
Correspondence to Dr Turgut Tatlisumak, Department of Neurology, Helsinki University Central Hospital, PO Box 300, 00029 HYKS Helsinki, Finland. E-mail turgut.tatlisumak{at}huch.fi
Background and Purpose—Endothelins (ETs) are potent vasoconstrictors and may play a role in the pathophysiology of several diseases. Limited and controversial data exist on their role in human ischemic stroke. We planned a prospective, observational, and longitudinal clinical study to test whether ET-1 levels increase in various phases of ischemic stroke and whether the ET-1 levels correlate with neurological scores, stroke etiology, stroke risk factors, or final outcome.
Methods—We measured plasma ET-1 levels with a sandwich-enzyme immunoassay method in 101 consecutive patients with ischemic stroke on admission and 1 week, 1 month, and 3 months after stroke and in 101 sex- and age-matched control subjects. At each sampling, the patients underwent a complete neurological evaluation. All stroke risk factors were recorded, an array of laboratory tests were performed, and the subtype of ischemic stroke was determined. The patients were contacted 3 years later for prognostic determination.
Results—ET-1 levels in patients (2.4±1.3 pg/mL on admission, 2.2±1.4 pg/mL at 1 week, 2.1±1.4 pg/mL at 1 month, and 2.1±1.2 pg/mL at 3 months) were not different from those of the control subjects (2.2±0.9 pg/mL) at any time point. No correlation was found between the ET-1 levels and stroke etiology, stroke risk factors, stroke recurrence risk, age, sex, or neurological scores, except that ET-1 levels correlated with the use of warfarin and with body mass index.
Conclusions—Plasma ET-1 levels were normal in patients with ischemic stroke. Our findings cannot exclude a role of ETs in the pathophysiology of ischemic stroke because plasma levels might not accurately reflect intracerebral concentrations, but they also do not support the occurrence of a major plasma ET-1 level increase at any phase of stroke. Our patient population is the largest ever reported in whom ET-1 levels were measured, but it consisted of mild and moderately ill patients with stroke due to the study design, of which the aim was long-term observation, which excludes severely ill patients.
Key Words: cerebral infarction • endothelins • prognosis • risk factors • stroke outcome
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