Antioxidant profile and early outcome in stroke patients

Background and Purpose-Experimental studies provide evidence of an associat ion between ischemic stroke and increased oxidative stress, but data in hum ans are still limited and controversial. The purpose of this study was to i nvestigate the time course of plasma antioxidant changes in ischemic stroke patients. Methods-Plasma antioxidants, including water-soluble (vitamin C and uric ac id) and lipid-soluble (vitamins A and E) compounds as well as antioxidant e nzyme activities in plasma (superoxide dismutase [SOD] and glutathione pero xidase) and erythrocytes (SOD), were measured by high-performance liquid ch romatography (antioxidant vitamins) and by spectrophotometry (antioxidant e nzymes) in 38 subjects (25 men and 13 women aged 77.2+/-7.9 years) with acu te ischemic stroke of recent onset (<24 hours) on admission, after 6 and 24 hours, and on days 3, 5, and 7. Antioxidant levels in patients on admissio n were compared with those of age- and sex-matched controls. Results-Mean antioxidant levels and activities in patients on admission wer e lower than those of controls and showed a gradual increase over time. Pat ients with the worst early outcome (death or functional decline) had higher vitamin A and uric acid plasma levels and lower vitamin C levels and eryth rocyte SOD activity than those who remained functionally stable. Conclusions-These results suggest that the majority of antioxidants are red uced immediately after an acute ischemic stroke, possibly as a consequence of increased oxidative stress. A specific antioxidant profile is associated with a poor early outcome.