Risk factors for ischemic stroke: differences between cerebral small vessel and large artery atherosclerosis

Yan Shi1,2, Li Guo2, Yangkun Chen3

  • 1Department of Rehabilitation Medicine, Xingtai People's Hospital, Xingtai, Hebei Province, China.

Folia Neuropathologica
|February 4, 2022
PubMed

Insights

Identifying risk factors for ischemic stroke subtypes is crucial. Large artery atherosclerosis (LAA) stroke risk factors include hypertension, high LDL, and smoking. Cerebral small vessel disease (SVD) stroke risk factors include hypertension, high total cholesterol, and smoking.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Large artery atherosclerosis (LAA) stroke and cerebral small vessel disease (SVD) are distinct ischemic stroke subtypes.
  • Understanding their unique risk factor profiles is essential for targeted treatment and prevention strategies.

Purpose of the Study:

  • To identify risk factors for ischemic cerebral SVD.
  • To compare the risk factor profiles of ischemic cerebral SVD and LAA stroke.

Main Methods:

  • A cohort of 353 acute ischemic stroke patients was classified into SVD or LAA groups using TOAST criteria.
  • A control group of 70 non-stroke patients was included.
  • Multivariate logistic regression (MLR) analyzed clinical variables including demographics, blood pressure, lipids, glucose, and lifestyle factors.

Main Results:

  • LAA stroke risk factors identified: hypertension, diabetes mellitus, high LDL, hypertriglyceridemia, and smoking.
  • Cerebral SVD stroke risk factors identified: hypertension, diabetes mellitus, high total cholesterol (TC), hypertriglyceridemia, and smoking.
  • High TC was a distinguishing factor for cerebral SVD, with SVD patients exhibiting higher TC levels compared to LAA patients.

Conclusions:

  • Hypertension, diabetes mellitus, high total cholesterol, hypertriglyceridemia, and smoking are independent risk factors for cerebral SVD stroke.
  • High total cholesterol is particularly prominent in cerebral SVD, differentiating it from LAA stroke.
  • These findings aid in differentiating stroke subtypes and informing personalized risk management.

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