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Inflammatory markers and conventional atherosclerotic risk factors in acute ischemic stroke: comparative study
Nijasri C Suwanwela1, Aurauma Chutinet, Kammant Phanthumchinda
1Neurological Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Rd, Bangkok 10330, Thailand. fmednsu@md2.md.chula.ac.th
Insights
Diabetes and elevated C-reactive protein indicate large vessel disease in stroke patients. Extracranial carotid stenosis shows higher C-reactive protein but lower cholesterol than intracranial stenosis.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Clinical Research
Background:
- Ischemic stroke is caused by large vessel atherosclerosis or small vessel disease.
- Large vessel disease can affect extracranial carotid or intracranial arteries.
Purpose of the Study:
- To identify differences in risk factors and inflammatory markers among ischemic stroke subtypes.
- To compare patients with large vessel disease (extracranial carotid vs. intracranial stenosis) and small vessel disease.
Main Methods:
- Compared risk factors and blood markers (C-reactive protein, HbA1c, lipids, etc.) in 116 acute ischemic stroke patients.
- Subdivided large vessel disease patients into extracranial carotid stenosis and intracranial stenosis groups.
Main Results:
- Large vessel disease patients showed higher prevalence of diabetes and C-reactive protein.
- Extracranial carotid stenosis patients had higher C-reactive protein than intracranial stenosis patients.
- Intracranial stenosis patients had higher cholesterol and LDL than small vessel disease patients.
Conclusions:
- Diabetes and elevated C-reactive protein are associated with large vessel disease.
- Higher C-reactive protein in extracranial carotid stenosis, but lower cholesterol/LDL compared to intracranial stenosis.
Background:
Large vessel atherosclerosis and small vessel disease are two major causes of ischemic stroke. In patients with large vessel disease, the lesions can be located in the extracranial carotid or intracranial arteries.
Objective:
To search for the differences of risk factors and inflammatory markers among patients with each subtype of vascular disease.
Material And Method:
Patients with acute ischemic stroke who had large vessel atherosclerosis or small vessel disease were studied. Patients with large vessel atherosclerosis were subdivided into extracranial carotid and intracranial stenosis groups. Blood samples were collected for c-reactive protein, erythrocyte sedimentation rate, hemoglobin A1C fibrinogen, fasting plasma glucose, cholesterol, triglyceride, and low-density and high-density lipoproteins. Risk factors and results of the blood tests between the groups of patients were compared.
Results:
There were 116 patients in the study. Sixty-three patients had large vessel disease, whereas 53 patients had small vessel disease. More prevalence of diabetes and higher c-reactive protein were significantly found in patients with large vessel disease. C-reactive protein on admission was also higher in patients with extracranial carotid stenosis than those with intracranial stenosis. Serum cholesterol and low-density lipoprotein was significantly higher in patients with intracranial stenosis than those with small vessel extracranial disease.
Conclusion:
Diabetes and higher c-reactive protein on admission were associated with large vessel disease. c-reactive protein was also higher in patients with extracranial carotid stenosis but their cholesterol and low-density lipoprotein were significantly lower than those with intracranial disease.
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