Elevated Lipoprotein-Associated Phospholipase A2 is Associated with Intracranial Atherosclerosis

2021 ◽  
Author(s):  
Yuan Wang ◽  
Gang Liu ◽  
Haiqing Song ◽  
Catherine Cao ◽  
Xunming Ji ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Phospholipase A2 ◽  
Artery Stenosis ◽  
The Other ◽  
Inflammatory Factor ◽  
Intracranial Atherosclerosis ◽  
Potential Therapeutic Target ◽  
Severe Stenosis ◽  
Increased Risk ◽  
Intracranial Artery Stenosis

Abstract BackgroundLipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory factor in atherosclerotic plaque pathogenesis and is associated with an increased risk of ischemic stroke. Whether Lp-PLA2 is associated with the stenosis subtypes in acute ischemic stroke (AIS) has not been investigated. Methods126 eligible AIS patients were divided into four groups 1) no cerebral artery stenosis (NCS); 2) intracranial artery stenosis (ICAS); 3) extracranial artery stenosis (ECAS); and 4) combined intracranial and extracranial artery stenosis (IECS). The associations between serum Lp-PLA2 levels and the stenosis subtypes were statistically assessed. ResultsThe ICAS group had a lower frequency of dyslipidemia as compared with the NCS group and the IECS group (35.3% vs. 70% vs. 71.8%, P=0.001), and was more likely to be symptomatic than the ECAS group (76.5% vs. 43.8%, P=0.014). The Lp-PLA2 level in the ICAS group was 112.2±66.8 μg/L, which was higher than that in the NCS, ECAS and IECS groups (81.7±38.5, 106.1±57.8, 89.3±52.2 μg/L, respectively, P=0.025). In the 3rd and 4th quartiles of Lp-PLA2 level, stenosis occurred more frequently in the ICAS group than in the other three groups (3rd Q: 50.0% vs. 3.1% vs. 28.1% vs. 18.8%, P=0.002; 4th Q: 48.4% vs. 16.1% vs. 25.8% vs. 9.7%, P=0.014). The Lp-PLA2 level was higher in patients with more or severe stenosis in the ICAS group. ConclusionsElevated Lp-PLA2 level was differentially associated with increased risk in AIS patients with ICAS as compared to those with ECAS or no stenosis. Lp-PLA2 is a promising biomarker for ICAS and may be a potential therapeutic target for ICAS.

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

2018 ◽  
Vol 4 (1) ◽  
pp. 49-60 ◽  
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.

Abstract T P101: Low Serum Eicosapentaenoic Acid- Arachidonic Acid Ratio is Associated With Intracranial Stenosis in Patients With Acute Ischemic Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yuko Abe ◽  
Ryoichi Otsubo ◽  
Sho Murase ◽  
Kenichiro Nakazawa ◽  
Kazuo Kitagawa
Keyword(s):  
Risk Factors ◽  
Arachidonic Acid ◽  
Ischemic Stroke ◽  
Eicosapentaenoic Acid ◽  
Acute Ischemic Stroke ◽  
Artery Stenosis ◽  
Intracranial Artery ◽  
Stroke Subtype ◽  
Fa Composition ◽  
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.

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

2013 ◽  
Vol 62 (1) ◽  
pp. 26-31 ◽  
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

Abstract 2552: Lipoprotein-associated phospholipase A2 predicts atherosclerotic stroke risk: The Northern Manhattan Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Mira Katan ◽  
Yeseon P Moon ◽  
Palma Gervasi-Franklin ◽  
Myunghee C Paik ◽  
Robert L Wolfert ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Phospholipase A2 ◽  
Degrees Of Freedom ◽  
Plaque Rupture ◽  
Large Artery ◽  
Serum Samples ◽  
Stroke Subtype ◽  
Entire Cohort ◽  
Improve Risk Stratification ◽  
Increased Risk

Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) has pro-inflammatory properties and may contribute to atherosclerosis, plaque rupture, and stroke. Lp-PLA2 levels may improve risk stratification, though whether this ability extends to all populations and stroke subtypes remains uncertain. We hypothesized that Lp-PLA2 levels would predict first ischemic stroke in a multiethnic, urban, population. Methods: Serum samples from stroke-free community participants in the Northern Manhattan Study were assayed using a microplate based ELISA to measure the mass concentration of Lp-PLA2 (PLAC Test, diaDexus, Inc). Participants were followed annually for stroke, and stroke subtype was determined according to the TOAST criteria. Cox proportional hazard models were fitted to estimate hazard ratios and 95% confidence intervals (HR, 95% CI) for the association of Lp-PLA2 mass levels with ischemic stroke, unadjusted and after adjusting for demographic, behavioral and medical risk factors. Results: Serum samples were available in 1946 participants with median follow up of 11 years; 151 subjects (7.8%) experienced a first ischemic stroke, of which 26 were large artery atherosclerotic strokes. Mean age was 69 (SD 10), 35.6% were men, 20% non-Hispanic Whites, 22% Blacks, and 55% Hispanics. The mean Lp-PLA2 level was 308.7 (SD 88.5) ng/mL. In non-Hispanic Whites, there was a trend toward increased risk of ischemic stroke with Lp-PLA2 levels (adjusted HR per SD 1.44, 95% CI 0.98-2.11), but not in Blacks (p for interaction with white=0.045); or in Hispanics (p for interaction with white=0.13). Lp-PLA2 levels were predictive of large artery atherosclerotic strokes (LAA) in the entire cohort (adjusted HR per SD 1.55, 95% CI 1.17-2.04). When analyzed by quartile, there were dose-response relationship with LAA (compared to the lowest quartile, 2nd quartile HR= 1.43, 95% CI 0.23-8.64; 3rd quartile HR=4.47, 95% CI 0.93-21.54; 4th quartile HR=5.07, 95% CI 1.07-24.06). When the analysis was stratified by race, Lp-PLA2 was associated with increased risk of LAA among whites, but not blacks or Hispanics (chi-squared 2 degrees of freedom, p for interaction=0.01). Conclusion: Lp-PLA2 was associated with risk of atherosclerotic stroke among non-Hispanic White participants, but not in other race-ethnic groups in the cohort. Further study is needed to confirm these race-ethnic differences and the reasons for them.

scholarly journals Intracranial Atherosclerosis Burden and Stroke Recurrence for Symptomatic Intracranial Artery Stenosis (sICAS)

2018 ◽  
Vol 9 (6) ◽  
pp. 1096 ◽  
Author(s):  
Ping Sun ◽  
Liping Liu ◽  
Yuesong Pan ◽  
Xianwei Wang ◽  
Donghua Mi ◽  
...  
Keyword(s):  
Artery Stenosis ◽  
Stroke Recurrence ◽  
Intracranial Atherosclerosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis

scholarly journals Challenge of Identifying the Cause of Intracranial Artery Stenosis in Patients With Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (3) ◽  
Author(s):  
Sylvain Lanthier ◽  
Céline Odier ◽  
Sophia Sundararajan ◽  
Daniel Strbian
Keyword(s):  
Ischemic Stroke ◽  
Artery Stenosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis

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

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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