title: Estradiol levels predict short-term adverse health outcomes in postmenopausal acute stroke women.
abstract: BACKGROUND
  Data on the role of endogenous sex steroids in cerebrovascular disease are sparse. Estradiol is a hormone with diverse actions on the central nervous system. Our aim was to investigate the role of circulating estradiol levels in a postmenopausal acute stroke population.
  
  
  METHODS
  During a time-period of 2 years, we prospectively studied 302 postmenopausal female patients hospitalized for an acute stroke in two tertiary hospitals. We addressed the question whether endogenous estradiol is associated with stroke severity on admission and functional outcome 1 month after stroke, as assessed by the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS), respectively.
  
  
  RESULTS
  Estradiol levels were significantly related to stroke severity on admission, as expressed by NIHSS, even after correcting for confounding factors in the multivariate analysis (beta 0.353, P < 0.001). Estradiol was an independent determinant of 1-month mortality and adverse functional outcome (mRS ≥ 4), [odds ratio (OR) with 95% confidence intervals (CI): 3.341 (1.617-6.902), P = 0.001 and 2.277 (1.273-4.074), P = 0.006, respectively].
  
  
  CONCLUSIONS
  We identified an independent association of endogenous estradiol levels with stroke severity and short-term mortality and outcome. These findings suggest challenging the role of estradiol as a neuroprotective agent.
authors.affiliation: Endocrine Unit, Department of Clinical Therapeutics, Athens University School of Medicine, Alexandra Hospital, Athens, Greece. dorispappas@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Pappa
authors.forename: K
authors.initials: K
authors.lastname: Vemmos
authors.forename: E
authors.initials: E
authors.lastname: Mantzou
authors.forename: P
authors.initials: P
authors.lastname: Savvari
authors.forename: K
authors.initials: K
authors.lastname: Stamatelopoulos
authors.forename: M
authors.initials: M
authors.lastname: Alevizaki
mesh_terms: D000368:Aged; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D017698:Postmenopause; D020127:Recovery of Function; D020521:Stroke / Q000097:blood*
chemical_list: D004958:Estradiol