Dataset Information

Association Between Serum Apolipoprotein A1 Levels, Ischemic Stroke Subtypes and Plaque Properties of the Carotid Artery.

ABSTRACT: Background:This study aimed to investigate the association between serum apolipoprotein A1 (ApoA1) levels, ischemic stroke subtypes and plaque properties. Methods:We enrolled 92 patients with ischemic stroke and 21 age-matched controls (CONT). The stroke patients were divided into three subtypes: cardioembolic (CE, n = 15), atherothrombotic infraction (ATBI, n = 52), and lacunar infarction (LI, n = 25). Carotid plaques were classified as low, intermediate, or high intensity, and either simple or mixed type. Serum lipids (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)), ApoA1, and ApoB were analyzed using commercially available kits. Results:There was no difference in TC, LDL-C, HDL-C, and ApoB levels among the four groups. Serum ApoA1 levels in the ATBI group were significantly lower compared with the CONT group. Among the ATBI group, the serum ApoA1 levels in the low-intensity plaque-type were significantly lower than those in the intermediate or hard-intensity plaque-type. Furthermore, serum ApoA1 levels in the mixed plaque-type were significantly lower than those in the simple type. Conclusions:These findings suggest that serum ApoA1 levels might be associated with the development of ATBI and plaque properties of the carotid artery.

SUBMITTER: Ohtani R

PROVIDER: S-EPMC7430921 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Association Between Serum Apolipoprotein A1 Levels, Ischemic Stroke Subtypes and Plaque Properties of the Carotid Artery.

Ohtani Ryo R Nirengi Shinsuke S Sakane Naoki N

Journal of clinical medicine research 20200815 9

<h4>Background</h4>This study aimed to investigate the association between serum apolipoprotein A1 (ApoA1) levels, ischemic stroke subtypes and plaque properties.<h4>Methods</h4>We enrolled 92 patients with ischemic stroke and 21 age-matched controls (CONT). The stroke patients were divided into three subtypes: cardioembolic (CE, n = 15), atherothrombotic infraction (ATBI, n = 52), and lacunar infarction (LI, n = 25). Carotid plaques were classified as low, intermediate, or high intensity, and e ...[more]

PMID: 32849948

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Project description:Background and Purpose- Carotid artery plaque with <50% luminal stenosis may be an underappreciated stroke mechanism. We assessed how many stroke causes might be reclassified after accounting for nonstenosing plaques with high-risk features. Methods- We included patients enrolled in the Cornell Acute Stroke Academic Registry from 2011 to 2015 who had anterior circulation infarction, magnetic resonance imaging of the brain, and magnetic resonance angiography of the neck. High-risk plaque was identified by intraplaque hemorrhage ascertained from routine neck magnetic resonance angiography studies using validated methods. Infarct location was determined from diffusion-weighted imaging. Intraplaque hemorrhage and infarct location were assessed separately in a blinded fashion by a neuroradiologist. We used the McNemar test for matched data to compare the prevalence of intraplaque hemorrhage ipsilateral versus contralateral to brain infarction. We reclassified stroke subtypes by including large-artery atherosclerosis as a cause if there was intraplaque hemorrhage ipsilateral to brain infarction, regardless of the degree of stenosis. Results- Among the 1721 acute ischemic stroke patients registered in the Cornell Acute Stroke Academic Registry from 2011 to 2015, 579 were eligible for this analysis. High-risk plaque was more common ipsilateral versus contralateral to brain infarction in large-artery atherosclerotic (risk ratio [RR], 3.7 [95% CI, 2.2-6.1]), cryptogenic (RR, 2.1 [95% CI, 1.4-3.1]), and cardioembolic strokes (RR, 1.7 [95% CI, 1.1-2.4]). There were nonsignificant ipsilateral-contralateral differences in high-risk plaque among lacunar strokes (RR, 1.2 [95% CI, 0.4-3.5]) and strokes of other determined cause (RR, 1.5 [95% CI, 0.7-3.3]). After accounting for ipsilateral high-risk plaque, 88 (15.2%) patients were reclassified: 38 (22.6%) cardioembolic to multiple potential etiologies, 6 (8.5%) lacunar to multiple, 3 (15.8%) other determined cause to multiple, and 41 (20.8%) cryptogenic to large-artery atherosclerosis. Conclusions- High-risk carotid plaque was more prevalent ipsilateral to brain infarction across several ischemic stroke subtypes. Accounting for such plaques may reclassify the etiologies of up to 15% of cases in our sample.

Project description:ImportanceIt remains unknown whether in an asymptomatic community-based cohort magnetic resonance imaging (MRI) measures of plaque characteristics are independently associated with incident cardiovascular disease (CVD) events when adjusted for carotid artery (CA) wall thickness, a measure of plaque burden.ObjectiveTo assess associations of CA MRI plaque characteristics with incident CVD events.Design, setting, and participantsThe Atherosclerosis Risk in Communities (ARIC) study is a prospective epidemiologic study of the incidence of CVD in 15 792 adults of which 2066 women and men were enrolled in the ARIC Carotid MRI substudy. ARIC participants were enrolled from 1987 to 1989, and the substudy was conducted between January 2004 and December 2005. Analysis began January 2017 and ended August 2020.ExposuresIncident CVD events during a median (interquartile range [IQR]) follow-up time of 10.5 (8.1-10.9) years were assessed.Main outcomes and measuresProportional hazards Cox analyses were performed to ascertain associations between MRI variables of CA plaque burden and plaque characteristics.ResultsOf 15 792 ARIC participants, 2066 were enrolled in the substudy, of whom 1256 (701 women [55.8%]) had complete data and were eligible for incident CVD analyses. Carotid artery plaques in participants with incident CVD events (172 [13.7%]) compared with those without (1084 [86.3%]) had a higher normalized wall index (median [IQR], 0.48 [0.36-0.62] vs 0.43 [0.34-0.55]; P = .001), maximum CA wall thickness (median [IQR], 2.22 [1.37-3.52] mm vs 1.96 [1.29-2.85] mm; P = .01), maximum CA stenosis (median [IQR], 5% [0%-22%] vs 0% [0%-13%]; P < .001), and when present, a larger lipid core volume (median [IQR], 0.05 [0.02-0.11] mL vs 0.03 [0.01-0.07] mL; P = .03), respectively. The presence of a lipid core was independently associated with incident CVD events when adjusted for traditional CVD risk factors and maximum CA wall thickness (hazard ratio, 2.48 [95% CI, 1.36-4.51]; P = .003), whereas the presence of calcification was not. The frequency of intraplaque hemorrhage presence in this population of individuals free of CVD at baseline who were not recruited for carotid stenosis was too small to draw any meaningful conclusions (intraplaque hemorrhage presence: 68 of 1256 participants [5.4%]). Carotid artery lumen area and maximum stenosis, which were overall low, were independently associated with incident CVD events when adjusted for traditional CVD risk factors, as anticipated.Conclusions and relevanceThe presence of a CA lipid core on MRI is associated with incident CVD events independent of maximum CA wall thickness in asymptomatic participants.

Dataset Information

Association Between Serum Apolipoprotein A1 Levels, Ischemic Stroke Subtypes and Plaque Properties of the Carotid Artery.

Publications

Association Between Serum Apolipoprotein A1 Levels, Ischemic Stroke Subtypes and Plaque Properties of the Carotid Artery.

Similar Datasets

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