scholarly journals Antioxidative activity of statins and HDL-PON1 association in lacunar ischemic stroke with and without white matter hyperintensity

2021 ◽  
Keyword(s):  
Antioxidant Activity ◽  
Ischemic Stroke ◽  
White Matter ◽  
Medical Center ◽  
Density Lipoprotein ◽  
Statin Treatment ◽  
Paraoxonase 1 ◽  
White Matter Hyperintensity ◽  
Pon1 Activity ◽  
Stroke Patients

Purpose: Statins (HMG-coA reductase inhibitors) protect vessels from atherosclerosis through various mechanisms, but the clinical significance of statin-induced high-density lipoprotein cholesterol (HDL) changes has not been established. We evaluated the effects of statin treatment on the antioxidative activities of HDLs in ischemic stroke patients with and without white matter hyperintensity (WMH). Methods: From January to December in 2013, eighty-two ischemic stroke patients (57 men, 25 women; mean age 67.0 ± 11.8 years) at the Wonkwang Medical Center were recruited retrospectively and antioxidant activity was assessed via paraoxonase 1 (PON1) activity. We studied changes in the patients’ lipid profiles and assessed PON1 activity in patients with and without WMH, at baseline and 8 weeks after treatment with rosuvastatin 10 mg/d. Results: All patients evaluated antioxidant activity using PON1 activity at admission. After 8 weeks of rosuvastatin treatment, the mean HDL concentration increased to 0.83± 10.1 mg/dL. The HDL levels increased in 54 patients (64.3%) and decreased in 30 patients (35.7%). PON1 activity increased to 15.0% in all patients, regardLess of WMH after rosuvastatin treatment (+ 25.4% in subjects without WMH; P < 0.001). Baseline PON1 activity modestly correlated with HDL levels (r = 0.365, P = 0.019); however, PON1 activity after treatment did not correlate with HDL levels (r = 0.149, P = 0.347). Conclusion: Our findings suggest that statins increase antioxidant activity, especially assessed via PON1 activity, in ischemic stroke patients who did not have WMH.

Low-density lipoprotein cholesterol lowering for the prevention of cardiovascular outcomes in patients with ischemic stroke

2019 ◽  
Vol 14 (5) ◽  
pp. 476-482 ◽  
Author(s):  
George Ntaios ◽  
Haralampos Milionis
Keyword(s):  
Ischemic Stroke ◽  
Cardiovascular Events ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Statin Treatment ◽  
Cardiovascular Outcomes ◽  
Stroke Patients ◽  
Pcsk9 Inhibitors ◽  
Cholesterol Levels

Background Low-density lipoprotein (LDL) cholesterol has been long associated with the risk for ischemic stroke, myocardial infarction, and cardiovascular death. For more than a decade, the main pharmacological option to prevent stroke and myocardial infarction through LDL-cholesterol lowering was the use of statins. During the recent years, two novel classes of drugs have proven their efficacy and safety to reduce LDL-cholesterol and prevent cardiovascular events in large, well-conducted randomized controlled trials: ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. Aims The present review summarizes the evidence arising from the latest trials of lipid-lowering treatment for cardiovascular outcomes prevention and discusses their implications for secondary prevention strategies in patients with ischemic stroke. Summary of review There is strong evidence which confirms the hypothesis that the lower the LDL-cholesterol, the less frequent the cardiovascular events are and underlines the importance of treating our ischemic stroke patients with intensive statin treatment aiming at low LDL-cholesterol levels. The very low levels of LDL cholesterol seem to be safe, even in the mid/long term but longer follow-up data are needed. Currently there are no tools to reliably predict cardiovascular outcomes in the specific population of ischemic stroke patients. Conclusions Stroke physicians should aim for low LDL-cholesterol levels by intensive statin treatment in all ischemic stroke patients. For those patients who are at the highest risk for recurrent stroke or another cardiovascular event and have unacceptable LDL-cholesterol levels despite intensive statin treatment, PCSK9 inhibitors should be considered.

scholarly journals White Matter Hyperintensity in Ischemic Stroke Patients: It May Regress Over Time

2015 ◽  
Vol 17 (1) ◽  
pp. 60 ◽  
Author(s):  
A-Hyun Cho ◽  
Hyeong-Ryul Kim ◽  
Woojun Kim ◽  
Dong Won Yang
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
White Matter Hyperintensity ◽  
Stroke Patients ◽  
Over Time

scholarly journals The efficacy of intravenous thrombolysis in acute ischemic stroke patients with white matter hyperintensity

2018 ◽  
Vol 8 (12) ◽  
pp. e01149 ◽  
Author(s):  
Yanyan Liu ◽  
Min Zhang ◽  
Hanmo Bao ◽  
Zhixiang Zhang ◽  
Yuqing Mei ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
White Matter Hyperintensity ◽  
Stroke Patients

Sonographic evaluation of atherosclerosis burden in carotid arteries of ischemic stroke patients and its relation to paraoxonase 1 and 2, MTHFR and AT1R genetic variants

2017 ◽  
Vol 378 ◽  
pp. 146-151 ◽  
Author(s):  
Carmen Rosa Hernández-Socorro ◽  
Francisco Javier Rodríguez-Esparragón ◽  
Jennifer Celli ◽  
Juan Carlos López-Fernández
Keyword(s):  
Ischemic Stroke ◽  
Genetic Variants ◽  
Carotid Arteries ◽  
Paraoxonase 1 ◽  
Stroke Patients ◽  
Sonographic Evaluation

scholarly journals Association of Ambulatory Blood Pressure and Heart Rate With Advanced White Matter Lesions in Ischemic Stroke Patients

2013 ◽  
Vol 27 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Hyuk Sung Kwon ◽  
Young-Hyo Lim ◽  
Hyun Young Kim ◽  
Hee-Tae Kim ◽  
Hyung-Min Kwon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Ischemic Stroke ◽  
White Matter ◽  
Ambulatory Blood Pressure ◽  
White Matter Lesions ◽  
Stroke Patients

Abstract TP476: White Matter Hyperintensity Burden is Associated With Poor Collateral Flow and Worse Outcomes in an Acute Ischemic Stroke Cohort

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Rami-James Assadi ◽  
Hongyu An ◽  
Yasheng Chen ◽  
Andria Ford ◽  
Jin-Moo Lee
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Pearson Correlation ◽  
Stroke Onset ◽  
White Matter Hyperintensity ◽  
Flow Index ◽  
Acute Ischemia ◽  
Collateral Flow ◽  
Core Volume

Introduction: White matter hyperintensity volume (WMHv), a quantitative neuroimaging biomarker of cerebral small vessel disease (CSVD), is associated worse outcomes after ischemic stroke. In this study, we hypothesized that worse outcomes in CSVD patients were due to poor collateral flow during acute ischemia. Methods: 47 patients with acute ischemic stroke (AIS) were prospectively enrolled in this study. Serial MRIs were performed at 3 hours and 30 days after stroke onset. 3-hour FLAIR images were used to determine WMHv, after manually delineating lesions with MIPAV. An index of collateral flow (delayed perfusion to the penumbra) was determined by subtracting core volume (volume of tissue with ADC<600) from the volume of brain tissue with Tmax>2. Patient’s NIHSS was scored at 3 hours and 30 days after stroke onset and the difference was calculated (ΔNIHSS). Log-transformed WMHv was correlated to ΔNIHSS and the collateral flow index, using Pearson correlation. Results: Mean age = 63.9 years (SD 13.5); 37% female; median 3-hour NIHSS = 13 (IQR 6.5-20); median change in NIHSS between 3h and 30d = 4 (IQR: 0-7); median core volume = 13cm3 (IQR 4.3-35.6); median WMHv = 1.257cm3 (IQR 641-3595). WMHv was associated with reduced improvement in ΔNIHSS (R=-0.42, ρ=0.005). Furthermore, WMHv demonstrated a trend for association with poor collateral flow (R=-0.28, ρ=0.062). In this dataset, we will explore the relationship between WMHv and other tissue-based metrics of collateral flow, including the hypoperfusion intensity ratio (HIR) and the cerebral blood volume ratio (rCBV). Conclusions: Our study confirms that patients with CSVD have worse outcomes after AIS. The data also raise the possibility that these worse outcomes in CSVD patients may be mediated by compromised collateral flow in the setting of acute ischemia.

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