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Association of higher serum calcium levels with smaller infarct volumes in acute ischemic stroke.
MedLine Citation:
PMID:  17846267     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Elevated serum calcium levels at admission in patients with stroke have been associated with less severe clinical deficits and with better outcomes; however, the relationship between serum calcium levels and volumetric measurement of cerebral infarct size on neuroimaging has not been studied, to our knowledge. OBJECTIVE: To assess the relationship between serum calcium levels at admission and initial diffusion-weighted magnetic resonance imaging (DWI) infarct volumes among patients with acute ischemic stroke. DESIGN: Secondary analysis of prospectively collected hospital quality improvement data. SETTING: Tertiary university hospital. PATIENTS: One hundred seventy-three consecutive patients with acute ischemic stroke initially seen within 24 hours of the last known well time. MAIN OUTCOME MEASURES: Total serum calcium levels were measured on admission and were collapsed into quartiles. The DWI lesions were outlined using a semiautomated threshold technique. The relationship between serum calcium level quartiles and DWI infarct volumes was examined using multivariate quartile regression analysis. RESULTS: One hundred seventy-three patients (mean age, 70.3 years [age range, 24-100 years]; median National Institutes of Health Stroke Scale score, 4 [range, 0-38]) met the study criteria. The median DWI infarct volumes for the serum calcium level quartiles (lowest to highest quartile) were 9.42, 2.11, 1.03, and 3.68 mL. The median DWI infarct volume in the lowest serum calcium level quartile was larger than that in the other 3 quartiles (P < .005). After multivariate analysis, the median adjusted DWI infarct volumes for the serum calcium level quartiles (lowest to highest) were 8.9, 5.8, 4.5, and 3.8 mL. The median adjusted DWI infarct volume in the lowest serum calcium level quartile was statistically significantly larger than that in the other 3 quartiles (P < .05). CONCLUSIONS: Higher serum calcium levels at admission are associated with smaller cerebral infarct volumes among patients with acute ischemic stroke. These results suggest that serum calcium level may serve as a clinical prognosticator following stroke and may be a potential therapeutic target for improving stroke outcome.
Brian H Buck; David S Liebeskind; Jeffrey L Saver; Oh Young Bang; Sidney Starkman; Latisha K Ali; Doojin Kim; J Pablo Villablanca; Noriko Salamon; Susan W Yun; Tannaz Razinia; Bruce Ovbiagele
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  64     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-11     Completed Date:  2007-10-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1287-91     Citation Subset:  AIM; IM    
Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Room A421, Toronto, ON M4N 3M5, Canada.
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MeSH Terms
Acute Disease
Aged, 80 and over
Brain / pathology
Brain Ischemia / complications*,  pathology
Calcium / blood*,  metabolism
Cerebral Infarction / pathology*
Cross-Sectional Studies
Extracellular Space / metabolism
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Middle Aged
Prospective Studies
Retrospective Studies
Stroke / blood*,  etiology*,  pathology
Grant Support
Reg. No./Substance:

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