Aim: The atherogenic index of plasma (AIP) was significantly related to adverse outcomes in patients with cardiovascular disease. Our aim was to investigate the association between AIP and adverse outcomes in acute ischemic stroke.Methods: Patients with acute ischemic stroke (AIS) admitted between 2015 and 2018 were prospectively enrolled in this study. Functional outcomes were evaluated by the modified Rankin Scale (mRS). Poor outcomes were defined as mRS 3–6. The relationship of AIP with the risk of outcomes was analyzed by multivariate logistic regression models.Results: A total of 1,463 patients with AIS within 24 h of symptom onset were enrolled. The poor outcome group had a significantly higher level of AIP [0.09 (−0.10 to 0.27) vs. 0.04 (−0.09 to 0.18), p < 0.001] compared with the good outcome group. Multivariable logistic regression analysis showed that higher AIP was associated with poor outcomes in all the stroke patients (OR 1.84, 95% CI, 1.23–2.53, p = 0.007), which was more evident in patients with large-artery atherosclerosis subtype (OR 1.90, 95% CI, 1.53–2.62, p = 0.002), but not in the other subtypes. Receiver operating curve (ROC) analysis revealed that the best predictive cutoff value of AIP was 0.112, with a sensitivity of 70.8% and a specificity of 59.2%, and the area under the ROC curves for AIP was 0.685.Conclusion: AIP may be an important and independent predictor of the outcome of dysfunction in patients with AIS, especially the stroke subtype of large-artery atherosclerosis.

Background: There is still no precise knowledge of the causes of progression in patients with acute ischemic stroke (AIS), and we are unable to predict patients at risk. Objective: To explore the frequency, predictive factors, and the prognosis of early neurological deterioration (END) in patients with AIS Methods: In this prospective multicenter observational study, we assessed patients with AIS admitted to 18 hospitals in Henan, China. We defined END as an increase of ⩾2 points in total National Institutes of Health Stroke Scale (NIHSS) score or ⩾1 point in the motor items of the NIHSS within 7 days after admission. Risk factors were analyzed using multivariate logistic regression models. Prognosis was evaluated using the modified Rankin Scale (mRS), with poor prognosis defined as mRS 3–6. Results: A total of 9114 patients with AIS within 24 h of symptom onset were enrolled in the study. END occurred in 1286 (14.1%) patients. The highest incidence (62.5%) of END occurred within 24 h after admission. After adjusting potential confounders, age, body mass index, waist–hip ratio, systolic blood pressure, baseline NIHSS, disabled at baseline, history of atrial fibrillation, diabetes mellitus, intracranial arterial stenosis, infarct location in the lenticulostriate artery area and cerebral watershed, neutrophils, lymphocytes, uric acid, and triglycerides were identified as independent predictors for END. END was significantly associated with poor prognosis at 90 days, and the adjusted OR was 1.74 (95% CI: 1.53–1.97). Conclusion: One in seven hospitalized patients with AIS may experience END within 24 h of onset. The highest incidence of END occurred within 24 h of admission and decreased steeply with time. Easily identifiable risk factors predict END and could help understand the causal mechanisms and thereby prevent END.

and Wang L ( ) Non-HDL-C/HDL-C ratio is associated with carotid plaque stability in general population: A cross-sectional study.

Background: Single small subcortical infarction (SSSI) is an isolated small infarction in the territory of perforating artery with a maximum diameter of 20 mm in axial diffusion-weighted imaging (DWI). About 20 to 30% of SSSI patients were reported to have early neurological deterioration (END) in the acute phase which brought adverse effects on long-term outcome. The effect of the alteplase on the outcome of SSSI, especially END and long-term outcome was ambiguous. Objective: To find out the efficacy and safety of intravenous recombinant tissue Plasminogen Activator(rt-PA) on long-term and short- outcomes of patients with SSSI as compared to patients who received standard medical care. Method: The patients were retrospectively screened from a stroke registry of the neurology department of 1st Affiliated Hospital of Zhengzhou University from January 2013 to December 2020.Based on treatment modality patients were dichotomized into alteplase and standard medical care group. To minimize confounding factors in subgroups, a propensity score matching analysis was done. The primary outcome was favorable functional outcome on 3 months after stroke onset defined by attaining score of ≤2 points on the modified Rankin scale (mRS), secondary outcome was prevention of occurrence of END defined as an increase of ≥2 points in total score or ≥1point on motor subunit in the National Institutes of Health Stroke Scale (NIHSS) score within 72 hour of symptoms onset, safety features were symptomatic intracranial hemorrhage (sICH) or death. Multivariate analysis was employed to find the efficacy and safety of alteplase on the treatment of SSSI. Results: A total of 717 patients with anterior circulation SSSI were selected, 132 were included in the final analysis. Forty-five patients were treated with alteplase within 4.5 hours and 87 with standard medical care and 44 pairs were successfully matched by propensity score. Pre-match data showed that alteplase thrombolysis group showed higher proportion of favorable outcomes at 3-month follow-up [ OR=0.315, 95%CI:0.106, 0.931, P=0.037], but did not reduce the incidence of END compared with the non-thrombolytic group [ OR=1.033, 95%CI :0.417,2.554, P=0.943]. Post-match data showed that the alteplase group also showed higher proportion of favorable outcomes at 3-month follow-up [ OR=0.247, 95%CI: 0.074, 0.830, P=0.024], however, it did not reduce the incidence of END compared with the non-thrombolytic group [ OR=1.241, 95%CI: 0.433,3.554, P=0.688]. There was one case of asymptomatic ICH in alteplase treated patients. Conclusion: Patients with SSSI in the anterior circulation are more likely to achieve 3 months favorable outcomes than those who were treated with standard medical care, however treatment with alteplase may not prevent occurrence of END.

Background: A certain number of patients with single subcortical small infarction (SSSI) in the lenticulostriate artery (LSA) territory present with early neurological deterioration (END). Objective: We sought to identify a more specific predicting imaging marker for END in lenticulostriate SSSI patients. Methods: We screened patients in a prospective hospital-based registry of stroke in the first Affiliated Hospital of Zhengzhou University from January 2015 to December 2020. Lesion locations were defined as posterior type when more than half of the lesion was located in the posterior part of the corona radiata divided by the midline, which was drawn between the tangents of the anterior and posterior horns of the lateral ventricle and was adjacent to the lateral ventricle at the same time. END was defined as an increase of ≥2 points in total National Institutes of Health Stroke Scale score or ≥1 point. A multivariate logistic analysis was used to assess the imaging predictors for END. Results: 418 patients were enrolled in the final data analysis. Among them, 206 (49. 3％) cases were rated as the posterior type and71（17. 0％）cases had to END. A multivariate logistic analysis showed that only the posterior type (adjusted odds ratio, 2. 126; 95% confidence interval, 1. 250–3. 614; P = 0. 005) was independently associated with the risk of END. Conclusion: The posterior type of lesion location represented an imaging marker predicting END in lenticulostriate SSSI patients.