Comparison of Plasma Lipoprotein Composition and Function in Cerebral Amyloid Angiopathy and Alzheimer’s Disease

Cerebral amyloid angiopathy (CAA) refers to beta-amyloid (Aβ) deposition in brain vessels and is clinically the main cause of lobar intracerebral hemorrhage (ICH). Aβ can also accumulate in brain parenchyma forming neuritic plaques in Alzheimer’s disease (AD). Our study aimed to determine whether the peripheral lipid profile and lipoprotein composition are associated with cerebral beta-amyloidosis pathology and may reflect biological differences in AD and CAA. For this purpose, lipid and apolipoproteins levels were analyzed in plasma from 51 ICH-CAA patients (collected during the chronic phase of the disease), 60 AD patients, and 60 control subjects. Lipoproteins (VLDL, LDL, and HDL) were isolated and their composition and pro/antioxidant ability were determined. We observed that alterations in the lipid profile and lipoprotein composition were remarkable in the ICH-CAA group compared to control subjects, whereas the AD group presented no specific alterations compared with controls. ICH-CAA patients presented an atheroprotective profile, which consisted of lower total and LDL cholesterol levels. Plasma from chronic ICH-CAA patients also showed a redistribution of ApoC-III from HDL to VLDL and a higher ApoE/ApoC-III ratio in HDL. Whether these alterations reflect a protective response or have a causative effect on the pathology requires further investigation.

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Mechanisms of cerebral amyloid angiopathy (CAA) in Alzheimer's Disease: Soluble Aβ protein in brain vessels

Neurobiology of Aging ◽

10.1016/0197-4580(94)92663-8 ◽

1994 ◽

Vol 15 ◽

pp. S51-S52

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebral Amyloid Angiopathy ◽

Amyloid Angiopathy ◽

Brain Vessels ◽

Cerebral Amyloid

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Relationship of neurofibrillary pathology to cerebral amyloid angiopathy in Alzheimer's disease

Neuropathology and Applied Neurobiology ◽

10.1111/j.1365-2990.2005.00663.x ◽

2005 ◽

Vol 31 (4) ◽

pp. 414-421 ◽

Cited By ~ 27

Author(s):

S. Williams ◽

K. Chalmers ◽

G. K. Wilcock ◽

S. Love

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebral Amyloid Angiopathy ◽

Amyloid Angiopathy ◽

Neurofibrillary Pathology ◽

Cerebral Amyloid ◽

Relationship Of

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[ 18 F]FDG PET may differentiate cerebral amyloid angiopathy from Alzheimer’s disease

European Journal of Neurology ◽

10.1111/ene.14743 ◽

2021 ◽

Author(s):

Sébastien Bergeret ◽

Mathieu Queneau ◽

Mathieu Rodallec ◽

Emmanuel Curis ◽

Julien Dumurgier ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebral Amyloid Angiopathy ◽

Fdg Pet ◽

Amyloid Angiopathy ◽

Cerebral Amyloid

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Abstract P418: Stroke Admissions and Outcomes Among Cerebral Amyloid Angiopathy and Alzheimer’s Disease in the National Inpatient Sample

Stroke ◽

10.1161/str.52.suppl_1.p418 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Nandakumar Nagaraja ◽

Urvish K Patel

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Hospital Mortality ◽

Cerebral Amyloid Angiopathy ◽

Amyloid Angiopathy ◽

Secondary Diagnosis ◽

National Inpatient Sample ◽

Admission Rates ◽

Secondary Outcomes ◽

Cerebral Amyloid

Background/Purpose: Although cerebral amyloid angiopathy (CAA) and Alzheimer’s Disease (AD) can manifest as separate diseases it can co-exist due to shared amyloid β pathogenic mechanisms. We assessed admission rates and outcomes of ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) among hospitalized patients with a secondary diagnosis of AD and CAA. Methods: Adult patients discharged with a secondary diagnosis of CAA or AD in National Inpatient Sample (NIS) in the years 2016 and 2017 were identified. Admission rates for IS, ICH, and SAH were primary outcomes. In-hospital mortality and discharge to home were secondary outcomes. Multivariate logistic regression analysis was performed to evaluate secondary outcomes with model adjusted for demographics, medical history, hospital characteristics, and Elixhauser comorbidity index. Results: Among 60,609,519 admissions in NIS, 893,834 (1.5%) patients had a secondary diagnosis of AD [mean age 82.1 years and 62% women] and 14,850 (0.02%) patients had CAA [mean age 76.2 years and 51% women]. Combined AD+CAA was present in 1,335 (0.002%) patients. Compared to AD and controls (non AD or CAA), patients with CAA had higher admission rates for IS (11.5% CAA vs 2.8% AD vs 1.7% control, p<0.0001), for ICH (29.5% CAA vs 0.4% AD vs 0.2% control, p<0.0001) and for SAH (3% CAA vs 0.1% AD vs 0.1% control, p<0.0001). Among patients admitted for IS, discharge to home was less likely in AD compared to controls (10.4% AD vs 36.3% control, OR=0.40; 95%CI=0.36-0.44). Among patients admitted for ICH, discharge to home was less likely in AD compared to controls (6.3% AD vs 18.5% control, OR=0.57; 95%CI=0.41-0.78) but higher in CAA (17.8% CAA vs 18.5% control, OR=1.35; 95%CI=1.11-1.63). In-hospital mortality was less likely in patients with CAA than controls among patients admitted for ICH (9.6% CAA vs 23% control, OR=0.33; 95%CI=0.26-0.41) and SAH (6.7% CAA vs 19.1% control, OR=0.27; 95%CI=0.11-0.62). Conclusion: Admissions for IS, ICH, and SAH were higher among CAA compared to AD in NIS. CAA patients had lower in-hospital mortality for ICH and SAH admissions and higher rates of home discharge for ICH admissions. AD patients were less likely to be discharged home for IS and ICH admissions.

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