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Lipid and hyperglycemia factors in first-ever penetrating artery infarction, a comparison between different subtypes

Shaoyang Sun1, Yanqiang Wang2, Yuge Wang3

  • 1Department of Neurology The Affiliated Hospital of Qingdao University Qingdao China.

Brain and Behavior
|June 23, 2017
PubMed

Insights

Branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD) in penetrating artery infarction (PAI) differ. Elevated LDL-C is linked to BAD progression, while age and HbA1c correlate with pontine penetrating artery infarction.

Area of Science:

  • Neurology
  • Cardiovascular Research
  • Metabolic Disorders

Background:

  • Branch atheromatous disease (BAD) pathogenesis and progression are debated, especially compared to lipohyalinotic degeneration (LD).
  • Limited research exists on lipid indices and glycometabolism in BAD within first-ever penetrating artery infarction (PAI).

Purpose of the Study:

  • To investigate lipid profiles and glycometabolism in patients with PAI.
  • To differentiate factors contributing to BAD versus LD in PAI.
  • To explore associations between these factors and stroke progression.

Main Methods:

  • Retrospective analysis of acute stroke patients with PAI admitted within 3 days.
  • Utilized diffusion-weighted MRI, MRA, and/or CTA for diagnosis.
  • Defined progression as ≥2-point increase in NIH Stroke Scale score; statistically analyzed clinical data.

Main Results:

  • BAD diagnosed in 57% and LD in 43% of patients.
  • Higher LDL-C in BAD patients (p=.013), linked to early neurological deterioration (p=.045).
  • Lenticulostriate artery (LSA) infarction more common (75.1%) than pontine penetrating artery (PPA) infarction (24.9%); PPA more prevalent in BAD (34.5% vs 12.1%, p<.001).
  • PPA infarction associated with older age at onset and higher HbA1c in BAD/LD patients (p=.014, p=.036).

Conclusions:

  • Elevated LDL-C may contribute to intracranial BAD pathogenesis and progression.
  • LSA infarction is the most frequent PAI subtype.
  • Age at onset and HbA1c are associated with PPA infarction in first-ever PAI.
Abstract

Keywords:
Intracranial branch atheromatous diseaseearly neurological deteriorationlipohyalinotic degenerationlow‐density lipoprotein cholesterolpenetrating artery infarction

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