Abstract 3372: The Ratio Of Apolipoprotein B-100 And A-i And Risk Of Intracranial Artery Stenosis In Acute Ischemic Stroke

Abstract

Background and Object: Intracranial artery stenosis (ICAS) is a common cause of acute ischemic stroke and has characteristics of poor prognosis and high recurrence. The role of plasma lipid level as risk factors for ICAS, still has controversy. So we investigated the relationship between the levels of the major lipids, apolipoproteins (Apo), lipoprotein (LP) and ICAS in acute ischemic stroke patients. Method: We assessed the clinical data of 881 consecutive patients from the stroke registry who were admitted due to TIA or acute ischemic stroke between November 2007 and January 2011. The major lipid levels [total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], the levels of Apo B100, Apo A-I and lipoprotein A [Lp (a)] and the level of high sensitivity C reactive protein (Hs-CRP) and were measured within three days after admission. The arterial segments were classified as normal, < 50 % stenosis or ≥ 50% stenosis on magnetic resonance angiography. ICAS was defined when at least one artery had ≥ 50% stenosis. Results: Of the total 881 patients, ICAS was found in 422 patients (31.0%, mean age: 66.17 ± 11.79 year old, males: 307), and 460 (55.7%) patients without ICAS were analyzed as a reference group. Compared with the reference group, the patients with ICAS were older (P < 0.001) and they had a greater prevalence of hyperlipidemia (p=0.002), a previous history of stroke (P =0.004) and no statin medication history (P < 0.001). The serum concentration of Hs-CRP was significantly higher in the patients with ICAS. (P < 0.001) The level of TC, LDL-C, HDL-C, Apo B100, Apo A-I, ratio of Apo B100/A-I and Lp (a) showed no significant difference between the two groups. But with adjustment of age, hypertension, diabetes mellitus, smoking, a previous history of stroke and statin medication, the ratio of Apo B100/ Apo A-I was significant for ICAS, (p=0.010) and was also the level of Hs- CRP (P=0.023). The odds ratios (ORs) for the presence of ICAS for those patients in the top, second, third quartiles were 2.054 (95% CI, 1.218-3.464), 1.721(95% CI, 1.033-2.868), and 1.667(95% CI, 1.008-2.757) sequentially for the ratio of Apo B100/ Apo A-I . Conclusions: Our study showed that the ratio of Apo B100/ Apo A-I was independently associated with presence of ICAS.