Ischaemic stroke is associated with an excessive release of
glutamate in brain. GOT (
glutamate-
oxaloacetate transaminase) and GPT (
glutamate-
pyruvate transaminase) are two
enzymes that are able to metabolize blood
glutamate facilitating the lowering of extracellular levels of brain
glutamate. Our aim was to study the association between blood levels of both
enzymes and
stroke outcome in patients with acute
ischaemic stroke. We prospectively studied 365 patients with first
ischaemic stroke<12 h.
Glutamate, GOT and GPT levels were determined in blood samples obtained at admission. We considered functional outcome at 3 months [good outcome: mRS (modified Rankin Scale)≤2; poor outcome mRS >2], END (early neurological deterioration) in the first 72 h [increment ≥4 points in NIHSS (National Institutes of Health
Stroke Scale)] and
infarct volume [CT (computed tomography) at 36-72 h] as end points. We have found an inverse correlation between GOT and GPT levels and blood
glutamate levels. Patients with poor outcome showed lower levels of GOT (11.9±8.2 compared with 22.7±10.2 m-units/ml, P<0.0001) and GPT (19.5±14.3 compared with 24.7±20.3 m-units/ml; P=0.004). A negative correlation has been found between GOT (Pearson coefficient=-0.477, P<0.0001) and GPT (Pearson coefficient=-0.116; P=0.027) levels and
infarct volume. Patients with END showed higher levels of blood
glutamate (381.7±97.9 compared with 237.6±114.0 μmol/l, P<0.0001) and lower levels of GOT (10.8±6.7 compared with 18.1±10.8 m-units/ml; P<0.0001). This clinical study shows an association between high blood GOT and GPT levels and good outcome in
ischaemic stroke patients, this association being stronger for GOT than GPT levels.