Association of serum calcium levels with clinical severity of acute ischemic stroke.
ABSTRACT Calcium (Ca) plays an important role in the pathogenesis of ischemic cell damage. Intracellular Ca accumulation leads neuronal damage by triggering the cycle of cytotoxic events, however the relationship of serum Ca levels and the pathways involved in ischemic injury is unclear. To investigate the effect of serum Ca on clinical features of ischemic stroke; the association of serum Ca levels measured in the first 24 hours with the severity of clinical symptoms on admission and short-term prognosis is evaluated.
158 consecutive patients who admitted to the hospital with ischemic stroke in the first 24 hours after the onset of symptoms were enrolled to the study. Serum total Ca levels, National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores on admission and mRS scores at discharge were recorded. Patients were classified according to serum total Ca levels into three groups and compared in terms of stroke risk factors, etiology, severity of clinical symptoms on admission and short term prognosis.
A total of 158 patients with acute ischemic stroke including 84 women and 74 men were enrolled in the study prospectively. NIHSS scores were higher in the groupl which consist of lower Ca levels compared with others (p < 0.05, p < 0.001 respectively), and they were found to be higher in group 2 than group 3 (p = 0.029). mRS scores at discharge showed no differences between groups. Except for coronary artery disease was more common in group 2, no statistically significant differences were determined in terms of stroke risk factors and etiology of stroke.
The results of our study reveal that lower Ca levels may be associated with more severe clinical symptoms on admission in acute stroke patients.