Abstract
ObjectiveThe aim of our study was to evaluate the associations between arterial stiffness indexes and immune-inflammatory markers in subjects with acute ischemic stroke with and without metabolic syndrome.Materials/MethodsWe enrolled 130 patients with acute ischemic stroke and metabolic syndrome, 127 patients with acute ischemic stroke without metabolic syndrome and 120 control subjects without acute stroke. Applanation tonometry was used to record the augmentation index (Aix) and pulse wave velocity (PWV). We also evaluated plasma levels of C-reactive protein (CRP), Interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), Interleukin-6 (IL-6) and Interleukin-10 (IL-10), E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand Factor (vWF) plasma levels, tissue plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1).ResultsIn subjects with acute ischemic stroke and metabolic syndrome we observed higher median plasma values of immuno-inflammatory markers. In acute ischemic stroke patients and metabolic syndrome in relation of each TOAST subtype we observed a more significant positive correlation between PWV and immuno-inflammatory markers.ConclusionsStroke subjects with acute ischemic stroke and metabolic syndrome showed a higher degree of immuno-inflammatory and arterial stiffness indexes possibly due to metabolic background of these types of patients that trigger a more intense immune-inflammatory activation irrespective of stroke subtype, whereas being related to stroke subtype in subjects without metabolic syndrome.
Highlights
Arterial stiffness is increasingly recognized as an important determinant of cardiovascular risk [1,2] and may be directly involved in the process of atherosclerosis [3]
Stroke subjects with acute ischemic stroke and metabolic syndrome showed a higher degree of immuno-inflammatory and arterial stiffness indexes possibly due to metabolic background of these types of patients that trigger a more intense immune-inflammatory activation irrespective of stroke subtype, whereas being related to stroke subtype in subjects without metabolic syndrome
Patient selection Patients were considered as having metabolic syndrome if they had ≥3 of the following components, based on modification of the NCEP/ATP III: hypertension defined as systolic blood pressure ≥130 mm/Hg and/or a diastolic blood pressure ≥85 mm/Hg, and by history of hypertension, raised plasma triglycerides (≥150 mg/dL [1.7 mmol/L]), low high-density lipoprotein cholesterol levels (≥40 mg/dL in men and ≥50 mg/dL in women), and impaired fasting glucose defined as fasting plasma glucose concentration ≥110 mg/dL (6.1 mmol/L), but less than the criteria for diabetes of ≥125 mg/dL (≥7.0 mmol/L)
Summary
Arterial stiffness is increasingly recognized as an important determinant of cardiovascular risk [1,2] and may be directly involved in the process of atherosclerosis [3]. Inflammation has been associated with an increased risk. There are some inconsistencies, a number of recent studies have suggested that in a healthy population, there may be a significant relationship between hs-CRP and measures of arterial stiffness [8,9]. Yasmin et al found hs-CRP to be related to pulse wave velocity (PWV) but not to Augmentation Index (AIx) [10]. Kampus et al found hs-CRP to be independently and significantly associated with AIx but not with the timing of the reflected pressure wave (RT) [8]. In patients with systemic vasculitis, in which hsCRP levels are markedly elevated, they were positively correlated with PWV and AIx [9]
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