Protruding atherosclerotic aortic plaques and dyslipidaemia: correlation to subtypes of ischaemic stroke

Area of Science:

• Cardiovascular Medicine
• Neurology
• Vascular Biology

Background:

• Ischaemic stroke is a leading cause of disability and mortality.
• Thoracic aortic plaques and dyslipidaemia are known risk factors for cardiovascular events.
• The specific association between aortic plaque characteristics, lipid profiles, and stroke subtypes requires further elucidation.

Purpose of the Study:

• To investigate the relationship between thoracic aortic plaques and dyslipidaemia in patients with ischaemic stroke.
• To determine if this association differs across ischaemic stroke subtypes, specifically atherothrombotic versus cardioembolic stroke.

Main Methods:

• Transoesophageal echocardiography was used to assess aortic plaques in 50 ischaemic stroke patients and 401 controls.
• The aorta was divided into proximal and distal segments for plaque evaluation.
• Lipid profiles, including low-density lipoprotein cholesterol and apolipoprotein B/A-I ratio, were analyzed.

Main Results:

• Protruding plaques (intima ≥ 4 mm) in the proximal aorta were significantly more common in stroke patients (28%) than controls (13%).
• Patients with atherothrombotic stroke exhibited higher proximal aortic plaque scores and elevated low-density lipoprotein cholesterol and apolipoprotein B/A-I ratios compared to cardioembolic stroke patients.
• Proximal aortic plaque score correlated positively with low-density lipoprotein cholesterol and apolipoprotein B/A-I ratio.

Conclusions:

• Severe proximal aortic plaques combined with dyslipidaemia are more prevalent in atherothrombotic stroke.
• Lipid analysis may aid in identifying and managing patients at high risk for atherothrombotic stroke.