scholarly journals Association between serum uric acid and carotid disease in patients with atherosclerotic acute ischemic stroke

Vascular ◽  
2018 ◽  
Vol 27 (1) ◽  
pp. 19-26 ◽  
Author(s):  
José Carlos Arévalo-Lorido ◽  
Juana Carretero-Gómez ◽  
Nicolás Roberto Robles Pérez-Monteoliva

Aim The role of serum uric acid in ischemic stroke is controversial. On the one hand, it has a role as neuroprotectant in acute phase, but on the other hand, it may promote atherosclerosis in carotid arteries. Our aim is to investigate the association of serum uric acid levels at admission of acute ischemic stroke patients with carotid disease. Methods Cross-sectional study of patients admitted due to acute ischemic stroke. Clinical and laboratory variables were recorded. The carotid disease was defined based on the findings of carotid echography intima to media thickness and stenosis. Patients were grouped according to these findings. Robust statistical methods were applied into analysis. Results A total of 245 patients were recruited through a stroke registry. Their values of serum uric acid were related to both carotid intima to media thickness and stenosis showing a positive relationship between serum uric acid levels and intima to media thickness by Pearson correlation ( p < 0.05). Similarly, after adjusting for all potential confounders, eGFR, glucose, age and serum uric acid levels, (OR 1.26 (95% CI 1.04 −1.52, p¼0.01), were identified as independent predictors for having a intima to media thickness ≥1 mm. Similarly, by grouping patients in tertiles of the serum uric acid distribution, we found a predominantly greater carotid disease in the tertile with the highest levels of serum uric acid ( p < 0.005). Conclusion Our study supports the hypotheses that serum uric acid levels have different roles in the case of ischemic stroke. Its effects on the vascular wall contribute to the development of atherosclerosis and carotid disease.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Bijoy K Menon ◽  
Eric E Smith ◽  
Shelagh B Coutts ◽  
Donald G Welsh ◽  
James E Faber ◽  
...  

Introduction: Leptomeningeal collaterals are native (pre-existing) anastomoses that cross-connect a small number of distal-most arterioles within the crowns of the cerebral artery trees. We seek to identify potentially modifiable determinants associated with variability in leptomeningeal collateral status in patients with acute ischemic stroke. Methods: Data is from the Keimyung Stroke Registry, a prospectively collected dataset of patients with acute ischemic stroke from Daegu, South Korea. Patients with M 1 segment middle cerebral artery (MCA) +/- intracranial internal carotid artery (ICA) occlusions on baseline CT-angio from May 2004 to July 2009 were included in the study.Baseline and follow-up imaging was analyzed at the imaging core lab of the Calgary Stroke Program. Two readers blinded to all clinical information assessed leptomeningeal collaterals on baseline CT-angio by consensus using the regional leptomeningeal score (rLMC). Results: Of 206 patients[mean age66.9±11.6 years, median baseline NIHSS 14 (IQR11-20), median stroke symptom onset to CT-angio time 166 minutes (IQR 96-262)], 133 patients (64.6%) had poor collateral status at baseline (rLMC score 11-20). On univariate analyses, patients with poor collateral status at baseline were older, hypertensive, had higher blood glucose values, higher white blood cell count at baseline, higher D-dimer and serum uric acid levels (measured next day morning) and were more likely to have metabolic syndrome as per ATP III criteria. Multivariable modeling identified metabolic syndrome (OR 3.22 95% CI 1.69-6.15, p<0.001), raised serum uric acid (per 1mg/dl OR 1.35 95% CI 1.12-1.62, p<0.01) and age (per year, OR 1.03 95% CI 1-1.05, p=0.03) as independent predictors of poor leptomeningeal collateral status at baseline. Conclusion: Metabolic syndrome and hyperuricemia are modifiable determinants associated with poor leptomeningeal collateral status in patients with acute ischemic stroke. This knowledge could potentially help in focusing research on appropriate therapeutic strategies for modulating function of leptomeningeal collaterals.


2015 ◽  
Vol 53 (3) ◽  
pp. 1753-1759 ◽  
Author(s):  
Zhongchao Wang ◽  
Yanlin Lin ◽  
Yuxiu Liu ◽  
Ying Chen ◽  
Bin Wang ◽  
...  

2012 ◽  
Vol 319 (1-2) ◽  
pp. 51-55 ◽  
Author(s):  
Irene Miedema ◽  
Maarten Uyttenboogaart ◽  
Marcus Koch ◽  
Berry Kremer ◽  
Jacques de Keyser ◽  
...  

Author(s):  
Hafizah Soraya Dalimunthe ◽  
Adi Koesoema Aman ◽  
Yuneldi Anwar

Elevated fibrinogen levels is related to the blood hyperviscosity, that causes low blood velocity. Non-contrast-enhanced transcranialDoppler (TCD) is used to evaluate blood flow from the cerebrovascular system. To know the relationship between fibrinogen levels andexamination of TCD in acute ischemic stroke through evaluation. A cross sectional study was admitted from July 2012-Juny 2013.The researchers determined the differences between fibrinogen and TCD in the stroke group and control. The researchers examinedthe relationship between fibrinogen and TCD examination in the stroke group. The fibrinogenwas measured with Clauss method. TheTCD was examined due to middle of the cerebral artery (MCA) and the Internal Carotid one Artery (ICA). The patients were diagnosedas ischemic stroke from head CT-scan. Statistical analyses employed the Independent T test, Anova test and Pearson correlation. Theresearchers had 24 patients and 24 controls that the Fibrinogen levels in stroke group is 549.16±104.84 mg/mL and in the control groupis 385.64±16.80 mg/mL. The researchers examined MCA in the stroke as well as the control and found the mean velocity 43.12±21.03and 56.97±6.22 (p=0.05), the peak velocity 74.17±32.58 and 94.55±14.11 (p=0.05) end diastolic velocity 23.27±12.66 and35.30±7.34 (p=0.00). In ICA, the stroke group and control and found the mean velocity 31.40±8.86 and 43.07±8.06 (p=0.00), thepeak velocity 54.99±11.50 and 75.04±16.04 (p=0.00) end diastolic velocity 18.23±7.67 and 25.64±5.24 (p=0.00). The correlationbetween fibrinogen and TCD in the stroke group was not significant on MCA and ICA, P>0.05. It can be concluded that the differencesbetween fibrinogen levels and TCD in the stroke group and control are significant. But there is no correlation between the fibrinogenand TCD in the stroke group.


2014 ◽  
Vol 6 (1) ◽  
pp. 22-27
Author(s):  
Shovan Kumar Das ◽  
Amit Sarkar ◽  
Subhraprakash Pramanik ◽  
Mitabha Bandyopadhyay ◽  
Koushik Mondal ◽  
...  

Introduction: Stroke is the second leading cause of mortality worldwide. Ischemic stroke is  more prevalent than hemorrhagic stroke and atherosclerosis is the major cause of ischemic stroke. The increased carotid artery intima-media thickness (CIMT) is considered to be useful indicator of early atherosclerosis. So, this study was aimed to correlate the relationship between atherosclerotic risk factors and intima-media thickness of carotid artery in patients with acute ischemic stroke. Material and Methods: In this cross-sectional study, 100 consecutive patients of acute ischemic stroke and 50 healthy relatives of patients as control were studied for presence of atherosclerotic risk factors and carotid artery intima?media thickness by B-mode Doppler ultrasonography.Results: In this age and sex matched study, higher CIMT measurement was found among patients of acute ischemic stroke than healthy controls (0.849 ± 0.196 vs 0.602 ± 0.092; p < 0.001). The CIMT was well correlated with smoking (Beta = 0.295; t = 5.728; 95% CI 0.088 to 0.181; p < 0.001); hypertension (Beta = 0.387; t = 6.518; CI 0.112 to 0.209; p < 0.001); di abetes (Beta = 0.237; t = 4.848; CI 0.074 to 0.175; p < 0.001); hypercholesterolemia (Beta = 0.292; t = 5.840; CI 0.096 to 0.195; p < 0.001), but not with age (p = 0.153). The CIMT was also found to be higher among acute ischemic stroke patients who were smoker, hypertensive, diabetic and hypercholesterolemic than non?smoker, normotensive, non-diabetic and normo-cholesterolemic respectively. Conclusion: The CIMT being indicator of atherosclerosis can be used as future predictor of ischemic stroke. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10301 Asian Journal of Medical Sciences Vol.6(1) 2015 22-27


Sign in / Sign up

Export Citation Format

Share Document