Combined Assessment of Elevated Plasma Lipoprotein-Associated Phospholipase A2 and Plaque Enhancement Improved Accuracy in the Risk of Acute Ischemic Stroke in Patients with Intracranial Artery Stenosis

Purpose: A low ratio of serum eicosapentaenoic acid to arachidonic acid (EPA/AA) has been associated with atherosclerotic disease. Few studies investigate the association of serum fatty acid (FA) composition with the acute ischemic stroke so far. Our aim of this study is to evaluate the relationships between FA composition and stroke subtypes, extra-/intracranial atherosclerotic stenoses, and other cerebrovascular indicators Methods: This study included 154 consecutive patients who were admitted to our hospital because of acute ischemic stroke between April 2011 and March 2012. We examined the FA composition and classical vascular risk factors. We conducted brain MRI/MRA, carotid ultrasonogram, transthoracic echocardiogram, 24hr Holter electrocardiogram, ankle brachial index (ABI) and pulse wave velocity (PWV) in order to evaluate the severity of atherosclerotic change, stroke subtype, and cardiovascular status. Results: The mean value of EPA/AA was 0.33±0.22 in all patients with acute cerebral infarction. The 154 patients in this study (mean age 71 years) were categorized as follows; large artery atherosclerosis (LA; n=57), small artery occlusion (SA; n=48), cardiogenic embolism (CE; n=18), and others (n=31). We found intracranial artery stenosis greater than 50% in 70 patients (45%). The intracranial artery stenosis was associated with low EPA/AA ratio (P=0.013) and low EPA concentration (P=0.013). This association remained significant (P<0.05) after controlling for classical atherosclerotic risk factors. We could not find a significant correlation between FA composition and stroke subtype. However, there was a tendency for the EPA/AA ratio of LA patients to be the lowest among all subtype groups. The EPA/AA ratio was not associated with ABI, PWV, prevalence of arrhythmia, or cardiac function. Conclusions: A low EPA/AA ratio was significantly associated with intracranial stenosis in patients with acute ischemic stroke. This study shows the EPA/AA ratio might be an important marker to reflect the cerebral artery stenosis.

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Plasma Levels of Apolipoprotein E and Risk of Intracranial Artery Stenosis in Acute Ischemic Stroke Patients

Annals of Nutrition and Metabolism ◽

10.1159/000343789 ◽

2013 ◽

Vol 62 (1) ◽

pp. 26-31 ◽

Cited By ~ 6

Author(s):

Yong-Jae Kim ◽

Seung-Min Lee ◽

Hyun-Ji Cho ◽

Hyun Ju Do ◽

Chang Hyung Hong ◽

...

Keyword(s):

Ischemic Stroke ◽

Apolipoprotein E ◽

Acute Ischemic Stroke ◽

Plasma Levels ◽

Artery Stenosis ◽

Intracranial Artery ◽

Stroke Patients ◽

Intracranial Artery Stenosis

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Prevalence of Intracranial Artery Stenosis in Patients with Acute Ischemic Stroke in a Tertiary Care Hospital of China

Journal of Nepal Medical Association ◽

10.31729/jnma.5201 ◽

2020 ◽

Vol 58 (229) ◽

Author(s):

Sandip Kumar Jaiswal ◽

Yan Fuling ◽

Min Li

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Posterior Circulation ◽

Artery Stenosis ◽

Care Hospital ◽

Intracranial Artery ◽

Anterior Circulation ◽

Intracranial Artery Stenosis

Introduction: Intracranial artery stenosis is the most common cause of acute ischemic stroke, especially among people in Asia. About its epidemiology, however little is understood. The goal of our research is to establish the prevalence of intracranial artery stenosis in patients with acute ischemic stroke in a tertiary care hospital. Methods: A descriptive cross-sectional study was done in 1006 acute ischemic stroke patients at Affiliated Zhongda Hospital, School of Medicine, Southeast University China from May 2018 to May 2019. Ethical approval was taken from the Ethical review committee of the institution. A convenient sampling method was done. Intracranial artery stenosis was diagnosed when evidence of acute ischemic stroke was found in the territory of approximately 2 50% stenosis identified by Transcranial Doppler ultrasound and confirmed by magnetic resonance angiography or computed tomography. Statistical analysis was done using the Statistical Package for the Social Sciences version 20. Results: The prevalence of intracranial artery stenosis was found in 331 (32.90%) patients at 95% Confidence interval (0.24-0.42%). Among 331 cases the anterior circulation artery stenosis was present on 201 (19.98%) patients, followed by posterior circulation artery stenosis on 80 (7.95%) patients, then anterior plus posterior circulation artery stenosis on 50 (4.97%) patients. Conclusions: Intracranial artery stenosis is one of the most causes of acute ischemic stroke in China. The proportion of anterior circulation artery stenosis was higher than that in the posterior circulation.

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Risk score to predict concurrent extracranial and intracranial artery stenosis in acute ischemic stroke

Journal of the Neurological Sciences ◽

10.1016/j.jns.2016.02.061 ◽

2016 ◽

Vol 363 ◽

pp. 232-235 ◽

Cited By ~ 1

Author(s):

Lili Wang ◽

Guoping Zhang ◽

Yun Zhang ◽

Rui Fu

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Risk Score ◽

Artery Stenosis ◽

Intracranial Artery ◽

Intracranial Artery Stenosis

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Role of sLOX-1 in intracranial artery stenosis and in predicting long-term prognosis of acute ischemic stroke

Brain and Behavior ◽

10.1002/brb3.879 ◽

2017 ◽

Vol 8 (1) ◽

pp. e00879 ◽

Cited By ~ 4

Author(s):

Xian-Mei Li ◽

Ping-Ping Jin ◽

Jie Xue ◽

Jie Chen ◽

Qin-Fen Chen ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Artery Stenosis ◽

Intracranial Artery ◽

Intracranial Artery Stenosis ◽

Long Term Prognosis

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Bypass Surgery for Ischemic Stroke Caused by Intracranial Artery Stenosis or Occlusion

Brain Science Advances ◽

10.26599/bsa.2018.9050003 ◽

2018 ◽

Vol 4 (1) ◽

pp. 49-60 ◽

Cited By ~ 1

Author(s):

Ismatullah Soufiany ◽

Khalil Ahmad Hijrat ◽

Spina Soufiany ◽

Lukui Chen

Keyword(s):

Ischemic Stroke ◽

Cerebral Artery ◽

Vegetative State ◽

Superficial Temporal Artery ◽

Case Series ◽

Temporal Artery ◽

Artery Stenosis ◽

Intracranial Stenosis ◽

Intracranial Artery ◽

Intracranial Artery Stenosis

Surgical revascularization may be beneficial in patients with ischemic stroke caused by intracranial stenosis or occlusion who are ineligible for thrombolysis. Objective To evaluate the outcome of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in ischemic stroke caused by intracranial artery stenosis or occlusion. Methods We retrospectively studied successive case series of 19 patients who underwent surgical treatment between 2013–2017 of STA-MCA bypass. Surgical procedure was performed for the patients with acute ischemic stroke who were ineligible for thrombolysis. Results Of the 19 patients enrolled, symptom aggravation occurred during medical treatment, the patients were ineligible for thrombolysis despite being within 8 hours of symptom onset. Bypass significantly improved National Institutes of Health Stroke Scale scores, mean patient age was 78.05 years (range, 39–78 y). However, male 11 (57.95%) out of nineteen patients were presented with left-sided-lesions while female 8 (42%) had right-sided lesions with significant infarction growth by diffusion weighted imaging achieved, after surgical maneuver. No major complications occurred intraoperatively, in contrast to 2 (10.5%) minor manifestation were suffering minor complications probably they included the remote infarction (posterior cerebral artery territory). Pooled analysis with our patients showed a significant neurological improvement and a good outcome in 13 (68.4%) patients without hemorrhage or any other complication, 6 (31.6%) patients with unfavorable outcome (severe disability 2; vegetative state 4, non of them are died 0;). Conclusion STA-MCA bypass may be beneficial to patients with acute stroke or stenosis in progress who are ineligible for medical therapy. Furthermore, it appears safe when the infarction is small. These findings indicate that STA-MCA bypass could be considered as a treatment option in selected patients with ischemic stroke caused by intracranial stenosis or occlusion.

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Abstract 3372: The Ratio Of Apolipoprotein B-100 And A-i And Risk Of Intracranial Artery Stenosis In Acute Ischemic Stroke

Stroke ◽

10.1161/str.43.suppl_1.a3372 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Hyun-Ji Cho ◽

Yong Jae Kim

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Reference Group ◽

Previous History ◽

Density Lipoprotein ◽

Intracranial Artery ◽

Intracranial Artery Stenosis ◽

History Of ◽

Statin Medication ◽

Hs Crp

Background and Object: Intracranial artery stenosis (ICAS) is a common cause of acute ischemic stroke and has characteristics of poor prognosis and high recurrence. The role of plasma lipid level as risk factors for ICAS, still has controversy. So we investigated the relationship between the levels of the major lipids, apolipoproteins (Apo), lipoprotein (LP) and ICAS in acute ischemic stroke patients. Method: We assessed the clinical data of 881 consecutive patients from the stroke registry who were admitted due to TIA or acute ischemic stroke between November 2007 and January 2011. The major lipid levels [total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], the levels of Apo B100, Apo A-I and lipoprotein A [Lp (a)] and the level of high sensitivity C reactive protein (Hs-CRP) and were measured within three days after admission. The arterial segments were classified as normal, < 50 % stenosis or ≥ 50% stenosis on magnetic resonance angiography. ICAS was defined when at least one artery had ≥ 50% stenosis. Results: Of the total 881 patients, ICAS was found in 422 patients (31.0%, mean age: 66.17 ± 11.79 year old, males: 307), and 460 (55.7%) patients without ICAS were analyzed as a reference group. Compared with the reference group, the patients with ICAS were older (P < 0.001) and they had a greater prevalence of hyperlipidemia (p=0.002), a previous history of stroke (P =0.004) and no statin medication history (P < 0.001). The serum concentration of Hs-CRP was significantly higher in the patients with ICAS. (P < 0.001) The level of TC, LDL-C, HDL-C, Apo B100, Apo A-I, ratio of Apo B100/A-I and Lp (a) showed no significant difference between the two groups. But with adjustment of age, hypertension, diabetes mellitus, smoking, a previous history of stroke and statin medication, the ratio of Apo B100/ Apo A-I was significant for ICAS, (p=0.010) and was also the level of Hs- CRP (P=0.023). The odds ratios (ORs) for the presence of ICAS for those patients in the top, second, third quartiles were 2.054 (95% CI, 1.218-3.464), 1.721(95% CI, 1.033-2.868), and 1.667(95% CI, 1.008-2.757) sequentially for the ratio of Apo B100/ Apo A-I . Conclusions: Our study showed that the ratio of Apo B100/ Apo A-I was independently associated with presence of ICAS.

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