Serum Caspase-3 Levels and Early Mortality of Patients with Malignant Middle Cerebral Artery Infarction
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Circulating caspase-3 levels at 24 h of ischemic stroke were found to be associated with poorer functional neurological outcome in a previous study. The aim of this study was to determine whether there is an association between serum caspase-3 levels and early mortality in patients with malignant middle cerebral artery infarction (MMCAI).
We included patients with MMCAI defined as computer tomography showing ischemic changes in more than 50% of the middle cerebral artery territory and Glasgow Coma Scale ≤ 8. Serum caspase-3 levels at days 1, 4, and 8 of MMCAI were determined.
Non-surviving MMCAI (n = 34) showed higher serum caspase-3 levels at days 1 (p < 0.001), 4 (p = 0.001), and 8 (p = 0.01) than surviving patients (n = 34). We found that the area under the curve of serum caspase-3 levels for prediction of mortality at 30 days was 88% (95% CI = 78–95%; p < 0.001). Multiple logistic regression showed that serum caspase-3 levels were associated with 30-day mortality (OR = 51.25; 95% CI = 8.30–316.31; p < 0.001).
The novel and more important findings of our study were that high serum caspase-3 levels were associated with mortality in MMCAI patients.
KeywordsCaspase-3 Cerebral infarction Patients Mortality
List of Abbreviations
Acute Physiology and Chronic Health Evaluation
Activated partial thromboplastin time
Chronic obstructive pulmonary disease
Fraction inspired of oxygen
Glasgow Coma Scale
International normalized ratio
Pressure of arterial oxygen
This study was supported by a Grant (OA18/011) from Fundación DISA a la Investigación Médica 2017 (Santa Cruz de Tenerife. Spain). Funding did not have influence in the study design, the collection, analysis, and interpretation of data, the manuscript writing, and the decision to submit it for publication.
LL conceived, designed and coordinated the study, participated in acquisition and interpretation of data, and drafted the manuscript. MMM, RS, LR, MA, JSV, JJC, and VGM participated in acquisition of data. APC and AFGR participated in blood determination levels. AJ participated in the interpretation of data. All authors revised the manuscript critically for important intellectual content, made the final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Source of Support
This study was supported by a grant (OA18/011) from Fundación DISA a la Investigación Médica 2017 (Santa Cruz de Tenerife. Spain).
Conflicts of interest
The authors declare that they have no conflict of interests.
Ethical Approval/Informed Consent
This study was carried after the approval of Institutional Review Board of all participating hospitals and with the written informed consent from legal guardians of patients.
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