Dataset Information

Sex Differences in Intracranial Atherosclerotic Plaques Among Patients With Ischemic Stroke

ABSTRACT:

Objective

High-risk intracranial arterial plaques are the most common cause of ischemic stroke and their characteristics vary between male and female patients. However, sex differences in intracranial plaques among symptomatic patients have rarely been discussed. This study aimed to evaluate sex differences in intracranial atherosclerotic plaques among Chinese patients with cerebral ischemia.

Methods

One hundred and ten patients who experienced ischemic events underwent 3T cardiovascular magnetic resonance vessel wall scanning for the evaluation of intracranial atherosclerotic disease. Each plaque was classified according to its likelihood of causing a stroke (as culprit, uncertain, or non-culprit). The outer wall area (OWA) and lumen area of the lesion and reference sites were measured, and the wall and plaque areas, remodeling ratio, and plaque burden (characterized by a normalized wall index) were further calculated. The composition (T1 hyperintensity, enhancement) and morphology (surface irregularity) of each plaque were analyzed. Sex differences in intracranial plaque characteristics were compared between male and female patient groups.

Results

Overall, 311 plaques were detected in 110 patients with ischemic stroke (81 and 29 male and female patients, respectively). The OWA (P < 0.001) and wall area (P < 0.001) of intracranial arterial lesions were significantly larger in male patients. Regarding culprit plaques, the plaque burden in male patients was similar to that in female patients (P = 0.178, odds ratio [OR]: 0.168, 95% confidence interval [CI]: −0.020 to 0.107). However, the prevalence of plaque T1 hyperintensity was significantly higher than that in female patients (P = 0.005, OR: 15.362, 95% CI: 2.280–103.49). In the overall ischemic stroke sample, intracranial T1 hyperintensity was associated with male sex (OR: 13.480, 95% CI: 2.444–74.354, P = 0.003), systolic blood pressure (OR: 1.019, 95% CI: 1.002–1.036, P = 0.031), and current smoker (OR: 3.245, 95% CI: 1.097–9.598, P = 0.033).

Conclusion

For patients with ischemic stroke, the intracranial plaque burden in male patients was similar to that in female patients; however, the plaque characteristics in male patients are associated with higher risk, especially in culprit plaques.

SUBMITTER: Yan X

PROVIDER: S-EPMC9280275 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Objective Acute ischemic stroke is a group of diseases characterized by high morbidity, high disability, high mortality, and high recurrence, and most patients are left with varying degrees of sequelae. Symptomatic intracranial atherosclerotic stenosis (sICAS) is a major cause of acute ischemic stroke pathogenesis, and its formation and progression are influenced by a combination of pathways including lipid metabolism and inflammatory response. sICAS has a high risk of clinical recurrence. Therefore, timely and effective assessment of intracranial vascular stenosis in acute ischemic stroke is particularly important for the diagnosis of sICAS, the treatment of stroke and the prevention of stroke recurrence.Method The aim of this study was to screen for unique differential proteins that are closely associated with sICAS in patients with acute ischemic stroke. Fourteen patients with acute ischemic stroke were included and divided into stenosis and control groups according to whether the intracranial vessels were stenosed or not. First, mass spectrometry was applied to all patients included using 4D Label-free proteome quantification technology to obtain the differential proteins between the two groups. Secondly, functional enrichment analysis using GO classification, KEGG pathway, Domain and other bioinformatics libraries were used to obtain differential protein-related enrichment trends. Then, the STRING (v.11.5) protein interaction network database was applied for comparison to obtain the differential protein interactions and corresponding target proteins. Finally, PRM was applied to validate the selected target proteins.Result 1096 proteins were obtained by mass spectrometry, of which the number of quantitatively comparable proteins was 991. When P value<0.05, a change in differential expression of more than 1.3 was used as the change threshold for significant up-regulation and less than 1/1.3 was used as the change threshold for significant down-regulation, resulting in a total of 46 differential proteins screened, of which 24 proteins were significantly up-regulated and 22 proteins were significantly down-regulated. In PRM experiments, five proteins involved in lipid metabolism and inflammatory response have been validated, namely A2M ,LBP, CTSG,CST3,FABP1.Conclusion By detecting the changes of these five proteins in acute ischemic stroke patients, we can provide a basis for the diagnosis of sICAS, the treatment of stroke and the prevention of stroke recurrence, and also help to promote the development of drugs for the prevention of acute ischemic stroke recurrence by combining Chinese and Western medicine.