Specific features of free radical processes in comorbid patients with acute stroke and transient ischemic attack

• Published in: Nevrologii͡a︡, neĭropsikhiatrii͡a︡, psikhosomatika Vol. 6; no. 2S; pp. 34 - 41
• Main Authors: Orlova, A.S., Silina, E.V., Rumyantseva, S.A., Stupin, V.A., Menshova, N.I., Orlov, V.A., Sinelnikova, T.G., Bolevich, S.B.
• Format: Journal Article
• Language: English
• Published: IMA-PRESS LLC 04.10.2014
• Subjects: comorbidity; free radicals; hyperglycemia; oxidative stress; stroke; transient ischemic attack
• ISSN: 2074-2711; 2310-1342
• DOI: 10.14412/2074-2711-2014-2S-34-41

Objective: to study the course of free radical processes (FRP) and the role of glycolytic disorders in patients with stroke and transient ischemic attack (TIA) developing in the presence of several vascular diseases (vascular comorbidity).Patients and methods. The study enrolled 141 patients aged 28–94 years (mean age 65.48±13.44 years) with stroke and TIA developing in the presence of vascular comorbidity. Ischemic stroke was diagnosed in 87 (61.7%) patients, hemorrhagic stroke and TIA were in 35 (24.8%) and 19 (13.5%) patients, respectively. Their neurological and functional status was evaluated over time using the U.S. National Institute of Health stroke scale, the Barthel index, and the Rankin scale. Plasma FRP was investigated over time from the oxygen and lipid peroxide markers of oxidative stress. After hospital discharge, the patients were followed up for 6 months to 6 years. Survival and recurrent cardiovascular event rates were estimated.Results. In the patients with prior stroke, the severity of vascular comorbidity correlated with the rise in death rates that within 6 years after hospital discharge were 42.9% and 8.3% in patients with 4 cardiovascular diseases (CVD) and 1 CVD, respectively. Vascular comorbidity correlated with the outcome of the disease. Emphasis was laid on the role of hyperglycemia in the breakdown of adaptive processes in stroke. The low level of malonic dialdehyde and the high antiperoxide activity of secondary plasma in the stroke patients are markers for good in-hospital functional recovery and reduced poststroke mortality rates during a long-term follow-up.Conclusion. Stroke and TIA develop in the presence of obvious vascular comorbidity that predetermines the severity of the disease. The FRP values correlating with dysenergetic processes are significant prognostic markers in both acute and chronic stroke.