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Updated: May 8, 2025

Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus
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Atherogenic Dyslipidemia Is Critically Related to Aortic Complicated Lesions in Cryptogenic Stroke

Muneaki Kikuno1,2, Yuji Ueno3,4, Yohei Tateishi5

  • 1Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

Journal of Atherosclerosis and Thrombosis
|December 25, 2024
PubMed

Insights

Atherogenic dyslipidemia (AD) affects over 10% of cryptogenic stroke (CS) patients and is linked to aortic complicated lesions (ACL). Intensive lipid-modifying therapy may benefit patients with CS and AD, particularly those with ACL.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Lipidology

Background:

  • Atherogenic dyslipidemia (AD), characterized by low HDL-C and high TG, is a residual risk factor for cardiovascular diseases.
  • AD is associated with atheromatous thrombotic brain infarction (ATBI) and potentially cryptogenic stroke (CS).
  • Aortic complicated lesions (ACL) are a significant embolic source for CS, with a risk of recurrent embolism.

Purpose of the Study:

  • To investigate the association between atherogenic dyslipidemia (AD) and cryptogenic stroke (CS).
  • To identify clinical features associated with AD in patients with CS.
  • To explore the relationship between AD and aortic pathologies in CS patients.

Main Methods:

  • Analysis of data from the CHALLENGE ESUS/CS study, including patients who underwent transesophageal echocardiography (TEE).
  • Definition of AD as HDL-C ≤ 40 mg/dl and TG ≥ 150 mg/dl.
  • Comparison of clinical features between patients with and without AD.

Main Results:

  • 10.2% of 664 CS patients met the criteria for AD.
  • Independent predictors of AD included higher body mass index, diabetes mellitus, ACL in the aortic arch, and in-hospital deterioration.
  • ACL in the arch was significantly associated with AD in CS patients.

Conclusions:

  • AD is prevalent in the CS population.
  • AD is critically linked to ACL in patients with CS.
  • Intensive lipid-modifying therapy may be beneficial for treating aortogenic brain embolism in CS patients.
Abstract

Keywords:
Aortic complicated lesionAtherogenic dyslipidemiaCryptogenic strokeEmbolic stroke of undetermined sourceTransesophageal echocardiography

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