Association between large artery atherosclerosis and cerebral microbleeds: a systematic review and meta-analysis

Ding, Lingling; Hong, Yuehui; Peng, Bin

doi:10.1136/svn-2016-000049

Cited by 18 publications

(5 citation statements)

References 43 publications

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“…However, the post hoc analytic approach may result in false-positive findings, and the mechanism underlying the association between microbleeds or PVS and bleeding events needs further investigation. Previous meta-analysis suggested that ICAS may be associated with microbleeds,26 our investigation did not find significant interaction between CSVD burden and ICAS, while CSVD may be associated with haemorrhagic events independently.…”

Section: Discussioncontrasting

confidence: 75%

Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

Chen¹,

Pan²,

Zong³

et al. 2020

Stroke Vasc Neurol

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BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p<0.001) and >1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, p<0.001) was associated with higher mRS scores. Severe CSVD (HR 10.70, 95% CI 1.16 to 99.04, p=0.04), but not ICAS, was associated with a higher risk of bleeding events. Six-point modified CSVD score improved the predictive power for bleeding events and disability.InterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589

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Section: Discussioncontrasting

confidence: 75%

Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

Chen¹,

Pan²,

Zong³

et al. 2020

Stroke Vasc Neurol

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show abstract

“…The presence of cerebral microbleeds is considered a strong predictor of future stroke, particularly haemorrhagic stroke. Ding et al 27 performed a systematic review and meta-analysis and found that there is a relationship between large artery atherosclerosis and cerebral microbleeds. Isolated medial layer thickness reflects not only early atherosclerosis but also nonatherosclerotic compensatory remodelling with large medial hypertrophy as a result of smooth muscle cell hyperplasia and fibrocellular hypertrophy 28 .…”

Section: Discussionmentioning

confidence: 99%

Etiopathogenic features of severe epistaxis in histological samples from individuals with or without arterial hypertension

Rezende

Oliveira

Soares

et al. 2022

Sci Rep

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There is a consensus that arterial hypertension (AH) is associated with stroke. Therefore, this study aimed to evaluate the histology of the microvasculature associated with the mucosa of the posterior nasal cavity to identify possible factors related to vascular weakening and rupture. Histological sections were obtained from hypertensive and normotensive individuals, regardless of epistaxis. Our results showed that the group with AH had: (a) smaller median diameter of the lumen of arteries and arterioles; (b) increased thickness of the intimal arteries and arterioles, slight inflammatory infiltrate, and rupture of internal elastic lamina; (c) greater thickness of the middle tunica in arterioles; (d) lower percentage of histological sections with non-injured intimal layers in capillaries, arterioles, and small arteries; (e) lower percentage of histological sections with intact media tunic and/or myocytes juxtaposed in arteries and arterioles; (f) no difference between the diameters of small arteries or arterioles. The intima was thicker in individuals with severe epistaxis than in the normotensive group, but it did not differ from the AH group. Thus, hypertension may cause structural lesions in the vascular layers, and in the absence of tissue repair and the persistence of AH, these lesions may favour vascular rupture, especially during hypertensive peaks.

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“…Pathologically, dysfunction of endothelial cells is a critical event in the pathological process of atherosclerosis, which leads to apoptosis of vascular arterial walls, atherogenesis, aortic plaque and macrophage infiltration (5)(6)(7). In addition, atherosclerosis is generally regarded as a lipid-induced chronic inflammation in the vessel wall, which leads to inflammatory lesions and apoptosis of endothelial cells (8)(9)(10). Thus, elucidating the possible mechanisms underlying the inflammatory process and apoptotic signal molecular pathways involved in the pathology of atherosclerosis are crucial to understand the occurrence and development of atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Pterostilbene reduces endothelial cell apoptosis by regulation of the Nrf2‑mediated TLR‑4/MyD88/NF‑κB pathway in a rat model of atherosclerosis

et al. 2020

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Endothelial cell injury in vascular arterial walls plays a crucial role in the pathological process of atherosclerosis. Pterostilbene, a stilbenoid chemically related to resveratrol, has anti-inflammatory, anti-apoptosis and antioxidant properties. However, the underlying mechanisms mediated by pterostilbene in regards to endothelial cell injury in vascular arterial walls are not fully understood. The purpose of the present study was to investigate the benefits of pterostilbene in a rat model of atherosclerosis. The possible mechanism of pterostilbene was also analyzed in regards to endothelial cell injury in vascular arterial walls in vitro. A rat model of atherosclerosis was established using endothelial injury of the iliac arteries. CCK-8 assay, TUNEL, immunofluorescence, western blot analysis and hematoxylin and eosin (H&E) staining were used to analyze the role of pterostilbene in the pathological processes of atherosclerosis. In vivo results showed that pterostilbene decreased cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) in plasma and attenuated interleukin (IL)-1, tumor necrosis factor (TNF)-α and IL-6 and oxidative stress injury in serum in the experimental animals. Pterostilbene treatment reduced atherogenesis, aortic plaques, macrophage infiltration and apoptosis of vascular arterial walls in the atherosclerosis rat model. In vitro assay demonstrated that pterostilbene administration increased viability of the endothelial cells, attenuated oxidative stress injury and apoptosis of endothelial cells. The results found that pterostilbene regulated endothelial cell apoptosis via the Nrf2-mediated TLR-4/MyD88/NF-κB pathway. In conclusion, data from the present study revealed that pterostilbene protects rats against atherosclerosis by regulation of the Nrf2-mediated TLR-4/MyD88/NF-κB pathway.

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Association between large artery atherosclerosis and cerebral microbleeds: a systematic review and meta-analysis

Cited by 18 publications

References 43 publications

Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

Etiopathogenic features of severe epistaxis in histological samples from individuals with or without arterial hypertension

Pterostilbene reduces endothelial cell apoptosis by regulation of the Nrf2‑mediated TLR‑4/MyD88/NF‑κB pathway in a rat model of atherosclerosis

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