Elevated Calcium after Acute Ischemic Stroke: Association with a Poor Short-Term Outcome and Long-Term Mortality.
- Author:
Jong Won CHUNG
1
;
Wi Sun RYU
;
Beom Joon KIM
;
Byung Woo YOON
Author Information
- Publication Type:Original Article
- Keywords: Cerebral infarction; Calcium; Patient outcome assessment
- MeSH: Calcium*; Cell Death; Cerebral Infarction; Humans; Logistic Models; Mortality*; Odds Ratio; Patient Outcome Assessment; Proportional Hazards Models; Prospective Studies; Risk Factors; Stroke*
- From:Journal of Stroke 2015;17(1):54-59
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND PURPOSE: An elevated intracellular calcium level is known to be a major initiator and activator of ischemic cell death pathway; however, in recent studies, elevated serum calcium levels have been associated with better clinical outcomes and smaller cerebral infarct volumes. The pathophysiological role played by calcium in ischemic stroke is largely unknown. METHODS: Acute stroke patients from a prospective stroke registry, consecutively admitted during October 2002-September 2008, were included. Significant associations between the modified Rankin scale distribution at discharge and serum calcium or albumin-corrected calcium were identified using ordinal logistic regression analysis. Cox proportional hazard models were used for survival analysis. RESULTS: Mean serum calcium and albumin-corrected calcium levels of the 1,915 participants on admission were 8.97+/-0.58 mg/dL and 9.07+/-0.49 mg/dL, respectively. Second [adjusted odds ratio 1.32 (95% confidence interval 1.07-1.61)] and third [1.24 (1.01-1.53)] tertiles of serum calcium level and the third [1.24 (1.01-1.53)] tertile of albumin-corrected calcium level were found to be independent risk factors for a poor discharge outcome. Significant relationships were observed with serum calcium [1.19 (1.03-1.38)] and albumin-corrected calcium [1.21(1.01-1.44)] as linear variables. However, only albumin-corrected calcium was associated with long-term mortality, third tertile [adjusted hazard ratio 1.40 (1.07-1.83)], and increase by 1 mg/dL [1.46 (1.16-1.84)]. CONCLUSIONS: Elevated albumin-corrected serum calcium levels are associated with a poorer short-term outcome and greater risk of long-term mortality after acute ischemic stroke.
