scholarly journals Serum Metabolomic Patterns in Young Patients with Ischemic Stroke

2020 ◽  
Author(s):  
Jia Liu ◽  
Junliang Yuan ◽  
Jingwei Zhao ◽  
Lin Zhang ◽  
Qiu Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Metabolic Pathways ◽  
Comprehensive Evaluation ◽  
Young Patients ◽  
Healthy Controls ◽  
Stroke Patients ◽  
Multivariate Statistical ◽  
Metabolomic Data ◽  
Common Risk Factors ◽  
Serum Metabolomics

Abstract Background: Ischemic stroke is one of the leading causes of death and adult disability. The incidence of ischemic stroke continues to rise in young adults. This study aimed to provide a comprehensive evaluation of metabolic changes and explore possible mechanisms in young ischemic stroke patients without common risk factors. Methods: This study investigated serum metabolomics in 50 young patients with newly suffered ischemic stroke and 50 age-, sex-, and body mass index–matched healthy controls. The metabolomic data were analyzed by performing a multivariate statistical analysis.Results: The 197 metabolites, including amino acids, bile acids, free fatty acids, and lipids, were identified in all participants. Multivariate models showed significant differences in serum metabolomic patterns between young patients with ischemic stroke and healthy controls. The stroke patients had increased L-methionine, homocysteine, glutamine, uric acid, GCDCA, and PE (18:0/20:4, 16:0/22:5), and decreased levels of L-citrulline, taurine, PC (16:2/22:6, 16:2/20:5, 15:0/18:2), and SM (d18:1/23:0, d20:0/19:1, d18:1/22:0, d16:0/26:1, d16:0/18:0, d16:0/22:1, d18:1/19:1, d16:0/17:1, d16:1/24:1, d18:1/19:0). Based on the identified metabolites, the metabolic pathways of arginine biosynthesis, glycerophospholipid metabolism, and taurine and hypotaurine metabolism were significantly enriched in the young patients with ischemic stroke. Conclusions: Serum metabolomic patterns were significantly different between young patients with ischemic stroke and healthy controls.

scholarly journals Serum Metabolomic Patterns in Young Patients with Ischemic Stroke: A Case Control Study

2020 ◽  
Author(s):  
Jia Liu ◽  
Junliang Yuan ◽  
Jingwei Zhao ◽  
Lin Zhang ◽  
Qiu Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Comprehensive Evaluation ◽  
Young Patients ◽  
Healthy Controls ◽  
Stroke Patients ◽  
Multivariate Statistical ◽  
Metabolomic Data ◽  
Common Risk Factors ◽  
Serum Metabolomics ◽  
Control Study

Abstract Background: Ischemic stroke is one of the leading causes of death and adult disability. The incidence of ischemic stroke continues to rise in young adults. This study aimed to provide a comprehensive evaluation of metabolic changes and explore possible mechanisms in young ischemic stroke patients without common risk factors. Methods: This study investigated serum metabolomics in 50 young patients with newly suffered ischemic stroke and 50 age-, sex-, and body mass index–matched healthy controls. The metabolomic data were analyzed by performing a multivariate statistical analysis.Results: The 197 metabolites, including amino acids, bile acids, free fatty acids, and lipids, were identified in all participants. Multivariate models showed significant differences in serum metabolomic patterns between young patients with ischemic stroke and healthy controls. The stroke patients had increased L-methionine, homocysteine, glutamine, uric acid, GCDCA, and PE (18:0/20:4, 16:0/22:5), and decreased levels of L-citrulline, taurine, PC (16:2/22:6, 16:2/20:5, 15:0/18:2), and SM (d18:1/23:0, d20:0/19:1, d18:1/22:0, d16:0/26:1, d16:0/18:0, d16:0/22:1, d18:1/19:1, d16:0/17:1, d16:1/24:1, d18:1/19:0). Based on the identified metabolites, the metabolic pathways of arginine biosynthesis, glycerophospholipid metabolism, and taurine and hypotaurine metabolism were significantly enriched in the young patients with ischemic stroke. Conclusions: Serum metabolomic patterns were significantly different between young patients with ischemic stroke and healthy controls.

Abstract TMP19: Intravenous Recombinant Tissue-type Plasminogen Activator Use in Young Adults With Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jodi A Dodds ◽  
Ying Xian ◽  
Shubin Sheng ◽  
Gregg Fonarow ◽  
Ronald A Matsouaka ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Older Patients ◽  
Young Patients ◽  
Tissue Type ◽  
Stroke Patients ◽  
Younger Patients ◽  
Tissue Type Plasminogen Activator ◽  
Type Plasminogen Activator

Background: Intravenous recombinant tissue-type plasminogen activator (rt-PA) administration improves outcomes in acute ischemic stroke. However, young patients (<40 years old) presenting with stroke symptoms may experience delays in treatment due to misdiagnosis or a reluctance to treat since they do not fit the profile of a typical stroke patient. Methods: We analyzed data from the large national Get With The Guidelines–Stroke registry for acute ischemic stroke patients hospitalized between January 2009 and September 2015. Multivariable models with generalized estimating equations (GEE) were used to test for differences between younger (age 18-40) and older (age > 40) acute ischemic stroke patients, controlling for patient and hospital characteristics including stroke severity. Results: Of 1,320,965 AIS patients admitted to participating hospitals, 2.3% (30,448) were aged 18-40. Among these patients, 12.5% received rt-PA versus 8.8% of those aged >40 (p<0.001). Of patients arriving within 3.5 hours of symptom onset without contraindications, 68.7% of younger patients received IV rt-PA versus 63.3% of older patients (adjusted OR [aOR] 1.30, 95% CI 1.21 to 1.40), without evidence that age-related differences varied by sex (interaction p-value 0.25). Odds ratios of achieving target door-to-CT times and door-to-needle (DTN) times, and outcomes of rtPA-treated patients, are shown in the Table. Conclusions: Young acute ischemic stroke patients did not receive rt-PA treatment at lower rates than older patients. Outcomes were better and the rate of symptomatic intracranial hemorrhage was lower in the young patients. However, younger patients had significantly longer door-to-CT and DTN times, providing an opportunity to improve the care of these patients.

scholarly journals Serum Metabolomics Revealed the Differential Metabolic Pathway in Calves with Severe Clinical Diarrhea Symptoms

Animals ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 769
Author(s):  
Mei-Zhou Huang ◽  
Dong-An Cui ◽  
Xiao-Hu Wu ◽  
Wang Hui ◽  
Zuo-Ting Yan ◽  
...  
Keyword(s):  
Metabolic Pathways ◽  
Fatty Acid Biosynthesis ◽  
Protein Digestion ◽  
Multivariate Statistical ◽  
Mineral Absorption ◽  
Calf Diarrhea ◽  
Catastrophic Disease ◽  
Liquid Chromatographic ◽  
Statistical Analysis Software ◽  
Serum Metabolomics

The complex etiology, higher morbidity and mortality, poor prognosis, and expensive cost of calf diarrhea have made it a catastrophic disease in the dairy industry. This study aims to assess the biomarkers in calves with diarrhea and to predict the biomarkers related to the pathway. As subjects, nine calves with diarrhea and nine healthy calves were enrolled, according to strict enrollment criteria. The serum metabolites were detected by a liquid chromatographic tandem mass spectrometry (LC-MS/MS), and then analyzed by online multivariate statistical analysis software to further screen the biomarkers. In addition, the biomarkers involved in the metabolic pathways of calves with diarrhea and healthy calves were analyzed. In the serum of calves with diarrhea, nine biomarkers were found to which several biomarkers exhibited a certain relation. Moreover, these biomarkers were involved in important metabolic pathways, including protein digestion and absorption, ABC transporters, aminoacyl-tRNA biosynthesis, mineral absorption, and fatty acid biosynthesis. All these findings suggested that the imbalance of these markers was closely related to the occurrence and development of calf diarrhea. The targeted regulation of metabolic pathways involved in these biomarkers may facilitate the diagnosis, treatment, and discussion of the mechanism of calf diarrhea.

scholarly journals Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

2019 ◽  
Vol 8 (2) ◽  
pp. 66-71
Author(s):  
Dipesh Shakya ◽  
Rabindra Shrestha ◽  
Krishna Dhungana ◽  
Raisha Kafle ◽  
Sabnam Bhatta
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Public Awareness ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Carotid Artery Atherosclerosis ◽  
Common Risk Factors

Background: Stroke is a disabling condition that has physical and mental impact on a patient’s life. Stroke is an important morbidity for low and middle income countries like Nepal. Hypertension, diabetes, smoking, and dyslipidemia are common risk factors in this regard and are inadequately controlled; mainly because of poor public awareness, inadequate infrastructure, lack of service and qualified manpower.Objectives: This study aims to provide insight into the epidemiology and risk factors in ischemic stroke patients.Methodology: A descriptive cross sectional study was conducted in 92 ischemic stroke patients at a tertiary care hospital Kathmandu Medical College and Teaching Hospital (KMCTH), Sinamangal, Nepal from December 2017 to June 2018. Consecutive sampling technique was used and data was collected from ischemic stroke patients above 14 years of age who were admitted in the Department of Neurology. Information regarding pre-morbid and morbid conditions, imaging findings as well as results was obtained from biochemical analysis of blood after taking consent from the patient or patient’s relative. Statistical Package for the Social Sciences Version 20 was used as a tool for statistical analysis.Results: Their mean age was 63.25 years with standard deviation of 16.45. Dyslipidemia was the most commonly found risk factor which was present in 77.2% of the subjects, followed by smoking (59.8%), presence of carotid artery atherosclerosis (59.8%), hypertension (50%), atrial fibrillation (26.1%) and diabetes mellitus(15.2%). Smoking was significant in males and heart disease was mostly seen in females.Conclusion: Dyslipidemia and smoking were the most common risk factors followed by carotid artery atherosclerosis. Patients with hypertension and dyslipidemia had higher incidence of stroke in both young and elderly group.

Classical and additional antiphospholipid antibodies in blood samples of ischemic stroke patients and healthy controls

2017 ◽  
Vol 65 (2) ◽  
pp. 470-476 ◽  
Author(s):  
Narin-Nard Carmel-Neiderman ◽  
David Tanne ◽  
Idan Goren ◽  
Pnina Rotman-Pikielny ◽  
Yair Levy
Keyword(s):  
Ischemic Stroke ◽  
Antiphospholipid Antibodies ◽  
Healthy Controls ◽  
Stroke Patients ◽  
Blood Samples

scholarly journals Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257697
Author(s):  
Brian Mac Grory ◽  
Erez Nossek ◽  
Michael E. Reznik ◽  
Matthew Schrag ◽  
Mahesh Jayaraman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Cryptogenic Stroke ◽  
Young Patients ◽  
Carotid Bifurcation ◽  
Stroke Patients

Introduction The carotid web is a compelling potential mechanism of embolic ischemic stroke. In this study, we aim to determine the prevalence of ipsilateral carotid web in a cohort of ischemic stroke patients and to perform a systematic review and meta-analysis of similar cohorts. Patients & methods We performed a retrospective, observational, cohort study of acute ischemic stroke patients admitted to a comprehensive stroke center from June 2012 to September 2017. Carotid web was defined on computed tomography angiography (CTA) as a thin shelf of non-calcified tissue immediately distal to the carotid bifurcation. We described the prevalence of carotid artery webs in our cohort, then performed a systematic review and meta-analysis of similar cohorts in the published literature. Results We identified 1,435 potentially eligible patients of whom 879 met criteria for inclusion in our analysis. An ipsilateral carotid web was detected in 4 out of 879 (0.45%) patients, of which 4/4 (1.6%) were in 244 patients with cryptogenic stroke and 3/4 were in 66 (4.5%) patients <60 years old with cryptogenic stroke. Our systematic review yielded 3,192 patients. On meta-analysis, the pooled prevalence of ipsilateral carotid web in cryptogenic stroke patients <60 was 13% (95% CI: 7%-22%; I2 = 66.1%). The relative risk (RR) of ipsilateral versus contralateral carotid web in all patients was 2.5 (95% CI 1.5–4.2, p = 0.0009) whereas in patients less than 60 with cryptogenic stroke it was 3.0 (95% CI 1.6–5.8, p = 0.0011). Discussion Carotid webs are more common in young patients with cryptogenic stroke than in other stroke subtypes. Future studies concerning the diagnosis and secondary prevention of stroke associated with carotid web should focus on this population.

scholarly journals The research of the relationships between patent foramen ovale and ischemic stroke in elderly patients

2020 ◽  
Author(s):  
Xu Chao Sun ◽  
Wenjing Jiang ◽  
Yan Zhao ◽  
Lin Ma ◽  
Yan Lin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Young Patients ◽  
Test Group ◽  
Control Group ◽  
Foramen Ovale ◽  
Stroke Patients ◽  
Shunt Volume

Abstract Background Research indicates that abnormal embolism caused by patent foramen ovale (PFO) may play an important role in cryptogenic stroke (CS). However, most researches has focused on young patients, and whether abnormal embolism caused by PFO also plays an important role in elderly CS is uncertain. The purpose of this study is to analyze the clinical characteristics of elderly patients with PFO, and to explore the correlation between elderly PFO and ischemic stroke.Methods 62 elderly patients diagnosed with ischemic stroke admitted to Qilu Hospital of Shandong University from April 2014 to April 2019 were selected as the Test Group. 62 non-stroke patients in our hospital's physical examination center and outpatient clinic were selected as the Control Group. Collect clinical data of patients for retrospective analysis.Results The incidence of PFO in the Test Group was significantly higher than that in the Control Group, the difference was statistically significant (p < 0.05). The proportion of large and medium shunt patients in the Test Group was significantly higher than that in the Control Group (p < 0.05). The proportion of patients with migraine in the PFO (+) group in the Test Group was significantly higher than the stroke patients in the PFO (-) group (p < 0.05).Conclusions The shunt volume of the PFO is related to ischemic stroke and may be a risk factor for ischemic stroke.

scholarly journals Relationship Between Homocysteine and Carotid Artery Stenosis in Ischemic Stroke

2013 ◽  
Vol 28 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Aminur Rahman ◽  
Firoz Ahmed Quraishi ◽  
Md Nurul Amin Miah ◽  
Maliha Hakim ◽  
Uttam Kumar Saha ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Homocysteine Level ◽  
Density Lipoprotein ◽  
Case Group ◽  
Healthy Controls ◽  
Vascular Risk ◽  
Stroke Patients ◽  
Artery Disease

Background: Epidemiologic studies have identified hyper-homocysteinemia as a possible risk factor for atherosclerosis. The aim of my study was based on evaluation of relationship between homocysteinemia with carotid artery stenosis in ischemic stroke patients.Methods and materials: It was a prospective observational study conducted in the Department of Neurology, Sir Salimullah Medical College & Mitford hospital, Dhaka. Thirty six consecutive patients with ischemic stroke were analyzed by serum total homocysteine, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride and extracranial Doppler ultrasonography and vascular risk factors were recorded. Equal number of controls of same ages were compared with the case group.Result: Mean fasting blood sugar, serum fasting total cholesterol (TC), serum fasting Low density lipoprotein (LDL) were significantly higher in case group (p=0.001). Serum TC and LDL had a positive correlation with serum homocystine (p=0.001). Serum High density lipoprotein (HDL) had a negative correlation (p=0.718) and serum triglyceride (TG) had a negative correlation (p = 0.182). Total plasma fasting homocysteine level in case group was 21.89 ± 9.38 ìmol/l and control group was 12.31 ± 3.27 ìmol/l, (p=0.001). Elevated fasting homocysteine level was found in 75.0% of the ischemic stroke patients and in 16.67% of healthy controls (p=0.001).On the basis of clinical evaluation and results of imaging studies, etiological classification of the ischemic stroke patients were made, where 36.1% cases were small artery disease, 38.9% large artery disease, 8.3% cases cardioembolic and in 16.7 % other causes. Among the cases, carotid duplex study was found normal in seven cases (19.4%), Group 1 findings in seven cases (19.4%), group 2 findings in eight cases (22.2%), group 3 findings in thirteen cases (36.1%) and group 4 findings in one case (2.8%). All abnormal carotid duplex findings were significantly higher among cases with elevated level of homocysteine (p=0.001, 0.001, 0.001).Conclusion: The incidence of hyperhomo-cysteinemia is higher in ischaemic stroke cases than that in age-sex matched healthy controls. Hyperhomocysteinemia in ischaemic stroke patients has been determined as vascular risk factor in our study. Significant correlation has been found between homocysteine concentration and intraluminal thickness and carotid artery stenosis.Bangladesh Journal of Neuroscience 2012; Vol. 28 (1): 1-9

scholarly journals Clinical Utility of Serum Holotranscobalamin Measurements in Patients with First-Ever Ischemic Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Oh Joo Kweon ◽  
Yong Kwan Lim ◽  
Mi-Kyung Lee ◽  
Hye Ryoun Kim
Keyword(s):  
Ischemic Stroke ◽  
Disease Severity ◽  
Functional Outcomes ◽  
Homocysteine Level ◽  
Healthy Controls ◽  
Stroke Patients ◽  
Short Term ◽  
B12 Deficiency ◽  
Multivariable Regression ◽  
The Impact

Background. Whether holotranscobalamin (holoTC) indicates B12 deficiency more sensitively than total vitamin B12 (B12) is unclear. This study is aimed at determining the impact of serum holoTC level as a risk factor for ischemic stroke and investigating its association with disease severity and short-term outcomes. Methods. Serum holoTC, total B12, and homocysteine levels were compared between 130 stroke patients and 138 healthy controls. Biomarker level correlations with disease severity and stroke functional outcomes were investigated. Results. holoTC levels were lower and homocysteine levels were higher in stroke patients than in healthy controls ( P < 0.05 ). The holoTC/total B12 ratio and homocysteine level significantly predicted ischemic stroke in the multivariable regression analysis ( P < 0.05 ). Along with hyperhomocysteinemia, patients more often had holoTC than total B12 deficiency (6.2% vs. 3.1%). holoTC levels negatively correlated with homocysteine levels (partial R -0.165, P < 0.05 ) in stroke patients in multiple linear regression analyses, but not total B12 levels. The holoTC level and holoTC/total B12 ratio, but not homocysteine and total B12 levels, negatively correlated with the National Institute of Health Stroke Scale (partial R , -0.405 and -0.207, respectively, P < 0.01 ). Conclusions. Measurements of serum holoTC levels combined with total B12 and homocysteine levels may provide valuable information for predicting ischemic stroke and its severity and short-term outcomes of ischemic stroke patients.

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