Atherosclerosis Cerebral Infarction Research Articles

The Role of Serum miR-497 on the Predictive Index of Early Diagnosis and Poor Prognosis of Atherosclerosis Cerebral Infarction.

Background:Serum miR-497 can be used as a predictive index of the early diagnosis and poor prognosis of atherosclerosis cerebral infarction (ATCI).Methods:Overall, 135 ATCI patients, treated in The Second Affiliated Hospital of Nantong University, Nantong 226001, P.R.China from Apr 2012 to Jan 2015, were included in ATCI group. Whereas, 77 patients with non-atherosclerosis cerebral infarction were put in the control group. RT-qPCR was performed for detecting serum miR-497 expression, whose relationship with the patients’ clinicopathological parameters was analyzed. Receiver operating characteristic (ROC) curves were plotted to evaluate values of serum miR-497 for diagnosing ATCI patients and their 3-year and 5-year overall survival rates (OSRs). Cox regression analysis was conducted on prognostic factors of ATCI patients.Results:miR-497 remarkably rose in the serum of ATCI patients, and was correlated with histories of hypertension, smoking and diabetes mellitus (DM). Its areas under curves (AUCs) for diagnosing these pathological parameters were 0.803, 0.817 and 0.819, respectively. Its expression was higher in the serum of the patients with recurrence and poor prognoses. Its AUCs for predicting the two conditions were 0.924 and 0.937, respectively. The 3- and 5-year OSRs of patients with low expression were remarkably higher than those of patients with high expression.Conclusion:miR-497 and histories of hypertension, smoking and DM were independent prognostic factors affecting the 3-year OSR of ATCI patients. miR-497 expression rises in ATCI patients, so this miR is expected to become a serum diagnostic marker for ATCI.

Triiodothyronine levels were positively correlated with opening of collateral circulation in cerebral infarction patients with large artery atherosclerosis.

IntroductionNon-thyroidal illness syndrome (NTIS) is one of the signs for poor prognosis of cerebral infarction (CI), but its risk factors had never been explored. In this study, we analyzed the potential effect of collateral circulation on prognosis prediction of triiodothyronine for large artery atherosclerosis cerebral infarction (LAA-CI) patients.Material and methodsClinical data of CI patients between 2012 and 2014 were collected. Imaging inspection was used for determining TOAST classification and evaluating collateral circulation. One-year follow-up was conducted for mRS score by telephone.ResultsT3 level in the NTIS group (p = 0.001) was significantly decreased while TSH level (p < 0.001) was increased. Patients in the NTIS group had a poorer prognosis (p = 0.008) and the main reason was the high mortality (p = 0.002). NTIS predicted poor collateral circulation (p = 0.026) and good collateral circulation tended to be less likely concomitant with NTIS (p = 0.001). Logistic regression analysis showed that triiodothyronine concentrations (OR = 4.760, 95% CI: 1.981–11.456, p < 0.001) were positively correlated with but advanced age (OR = 0.756, 95% CI: 0.645–0.886, p = 0.001) negatively with opening of collateral circulation.ConclusionsPoor opening of collateral circulation was likely to mediate the prediction of NTIS for prognosis of LAA-CI patients.

Evaluation of the relationship between carotid plaque neovascularization and leukocyte in patients with cerebral infarction by contrast-enhanced ultrasound

Objective To detecte the neovascularizations in carotid plaques using contrast-enhanced ultrasound (CEUS) and explore the relationship between the neovascularizations and the peripheral leukocytes in the patients with acute cerebral infarction. Methods Sixty-two patients with large artery atherosclerosis cerebral infarction were selected as cerebral infarction group; and 54 age-and gender-matched patients with atherosclerosis and without cerebral cerebrovascular events were recruited control group. The dominant carotid artery plaques were performed by CEUS, the peak of time-intensity curve (TIC-P) and the mean of time-intensity curve (TIC-M) were measured by off-line quantitative analysis. The peak (FC-P), time to peak (FC-TP), sharpness (FC-S) and under the curve area (FC-AUC) were obtained from fitting curves of time-intensity. The correlations between parameters of contrast-enhanced ultrasound and leukocyte counts were analyzed by Pearson correlation analysis. Results ①In the cerebral infarction group, the total leukocytes and neutrophils were higher than those in the control group, while the number of lymphocytes was lower than that of the control group (all P<0.05). ②In the cerebral infarction group, the TIC-P and TIC-M values were greater than those in the control group (P<0.05). Compared with the control group, the FC-P, FC-S and FC-AUC values in the cerebral infarction group were increased (all P<0.05). ③There was a negative correlation between PIG-P, TIC-M of FC-P and lymphocytes (r=-0.291, -0.263 and -0.270; all P<0.05). FC-S and FC-AUC were positively correlated with neutrophils (r=0.261, 0.298; all P<0.05). Conclusions Carotid plaque neovascularizations is related to peripheral leukocyte count. CEUS help us know more the vulnerability of plaque. Key words: Contrast-enhanced ultrasound; Cerebral infarction; Plaque, atherosclerotic; Carotid artery; Leukocyte

A modified Essen Stroke Risk Score for predicting recurrent ischemic stroke at one year

ObjectiveThe Essen Stroke Risk Score (ESRS) is widely used to predict the risk of recurrent ischemic stroke but may not have sufficient discriminatory ability for predicting early recurrence. In this study, we developed a modified ESRS for predicting recurrent ischemic stroke at one year based on Chinese population.MethodsEight hundred and three consecutive patients were included in the study. We performed a univariate analysis to investigate the effect of previously identified risk factors on recurrent stroke at one year. The candidate predictors were included in a forward stepwise logistic regression model. Prediction scores were assigned based on β coefficient and a modified ESRS system was constructed. We used receiver operating characteristic (ROC) curves to compare the predictive ability of the modified and original ESRS.ResultsRecurrent ischemic stroke occurred in 85 (11.00%) patients and death occurred in 68 (8.80%) patients within one year. Hypertension over 15 years, diabetes over 10 years, large artery atherosclerosis cerebral infarction by TOAST criteria and a history of transient ischemic attack (TIA) or ischemic stroke (IS) were identified as independent risk factors for recurrent stroke (all P < 0.05). The areas under the ROC curves of ESRS and modified ESRS were 0.58 (P < 0.05, 95%CI: 0.51–0.64) and 0.70 (P < 0.05, 95% CI: 0.63–0.76), respectively. The modified ESRS appears to be superior to the original ESRS for predicting recurrent ischemic stroke at one year (P < 0.05).ConclusionsThe modified ESRS increased the ability of the original ESRS to predict recurrent stroke at one year among the Chinese population.

Association between tumor necrosis factor superfamily member 4 gene polymorphism and risk of asymptomatic carotid vulnerable plaque in a Chinese population

Vulnerable plaque of carotid artery is one of the risk factors of atherosclerotic cerebral infarction. Detection and treatment of vulnerable atherosclerotic plaque of carotid artery before symptoms of cerebral infarction is an effective way to prevent atherosclerotic cerebral infarction. Tumor necrosis factor superfamily member 4 (TNFSF4) plays a key role in the process of atherosclerosis, a common risk factor for both myocardial and cerebral infarctions. Studies have indicated that the single nucleotide polymorphism (SNP) rs3850641 in TNFSF4 is associated with higher risk of myocardial infarction and SNP rs3861950 in TNFSF4 is associated with higher risk of atherosclerosis cerebral infarction (ACI) ,but little is known about the association between TNFSF4 variations and vulnerable plaque of carotid artery. A case-control study involving 510 patients with asymptomatic vulnerable plaque of carotid artery and 485 age and sex matched healthy subjects without vulnerable plaque of carotid artery was conducted in Hunan province. Asymptomatic vulnerable plaque of carotid artery means vulnerable plaque of carotid artery without cerebral infarction. Two SNPs of TNFSF4, rs3850641 and rs3861950, were genotyped by the TaqMan SNP genotyping method, and verified partly by Genomic DNA Sequencing. The results revealed a significant allelic association between rs3861950 and asymptomatic vulnerable plaque of carotid artery in case group (χ(2)=9.13, P=0.003; OR=1.41, 95%CI: 1.12-1.76). Compared with control subjects, the difference in genotype was significant in case group (χ(2)=25.28, P<0.000 1). However, there was no significant association between rs3850641 and asymptomatic vulnerable plaque of carotid artery (OR=1.16, 95%CI: 0.92-1.46; χ(2)=1.47, P=0.225). TNFSF4 gene polymorphism rs3861950 was associated with the risk of vulnerable plaques of carotid artery in a Chinese population, which might be middle phenotype indicating higher risk of cerebral infarction.

Association between adiponectin receptor 2 gene polymorphisms and cerebral infarction.

We examined the association between the adiponectin receptor 2 gene and the risk of ischemic stroke. Polymerase chain reaction-restriction fragment length polymorphism was used to detect rs12342 genotypes of the adiponectin receptor 2 gene in 300 ischemic stroke patients and 320 age- and gender-matched healthy controls. In the patient group, the AA, GA, and GG genotype frequencies were 39.3, 42.7, and 18.0%, respectively. The A and G allele frequencies were 0.607 and 0.393, respectively. In the control group, the AA, GA, and GG genotype frequencies were 29.0, 51.7, and 19.3%, respectively. The A and G allele frequencies were 0.548 and 0.452, respectively. The AA genotype and A allele frequencies in the patient group were significantly higher than those in the control group (both P < 0.01). The risk of ischemic stroke in AA genotype carriers was 1.786-fold greater than that in GG genotype carriers (odds ratio = 1.786, 95% confidence interval: 1.432-2.775; P = 0.013). After adjusting for various confounding factors, the difference remained significant (odds ratio = 1.874, 95% confidence interval: 1.221-2.765; P = 0.012). The AA genotype and A allele of rs12342 in the adiponectin receptor 2 gene may increase the risk of ischemic stroke, particularly the risk of atherosclerosis cerebral infarction.

TNFSF4 gene polymorphism rs3861950 but not rs3850641 is associated with the risk of cerebral infarction in a Chinese population

Tumor necrosis factor superfamily member 4 (TNFSF4) plays a key role in the process of atherosclerosis, a common risk factor for both myocardial and cerebral infarctions. Recent studies indicate that the single nucleotide polymorphism (SNP) rs3850641 in TNFSF4 is associated with higher risk of myocardial infarction, but little is known about the association between TNFSF4 variation and cerebral infarction (CI). A case-control study involving 385 CI patients and 385 age-matched, sex-matched non-CI controls was conducted in a Chinese population, only the most common subtype, atherosclerosis CI, was recruited. Two SNPs of TNFSF4, rs3850641 and rs3861950, were genotyped by the TaqMan SNP genotyping method, and verified partly by genomic DNA sequencing. The results revealed a significant allelic association between rs3861950 and CI (Odds ration=1.733, 95% confidence interval=1.333-2.254, P=0.000). Genotypic association analysis demonstrated that the CC genotype of rs3861950 confers susceptibility to CI (Odds ration=2.896, 95% confidence interval=1.368-6.132), and it was associated with a significantly higher risk of ischemic stroke (Odds ration=3.520, 95% confidence interval=1.546-8.015, P=0.003) after adjusting for the other confirmed risk factors such as the history of hypertension, diabetes, CAD, smoking and alcohol drinking. While the odds ratio of the T allele to the C allele was 1.733 (95% confidence interval: 1.333-2.254). However, there was no significant association between rs3850641 and CI (Odds ration=1.288, 95% confidence interval=0.993-1.670, P=0.056). TNFSF4 gene polymorphism rs3861950, but not rs3850641, is associated with the risk of atherosclerosis CI in a Chinese population.