Biomarkers Related to Carotid Intima-Media Thickness and Plaques in Long-Term Survivors of Ischemic Stroke

Abstract

Lifestyle risk factors, inflammation and genetics play a role in the development of atherosclerosis. We therefore studied Fc gamma receptor (FcγR) polymorphisms, interleukin (IL)-10 polymorphisms and other biomarkers related to carotid intima-media thickness (cIMT) in patients with ischemic stroke at a young age. Patients were evaluated 12 years after stroke occurrence. Patients (n = 232) 49 years of age or younger with an index stroke between 1988 and 1997 were retrospectively selected. Blood samples were taken at a first follow-up 6 years after the stroke. At a second follow-up, additional arterial events were registered for 140 patients, new blood samples were taken, and measurements of cIMT and blood pressure (BP) were performed. Unadjusted logistic regression analysis showed that cIMT ≥1 mm was associated with age, male gender, additional arterial events, BP, cholesterol, sedimentation rate, haemoglobin, triglycerides, creatinine, glycolysed haemoglobin (HbA1c) and FcγRIIIB-NaII/NaII. Adjusted backward stepwise logistic regression showed significance for age (odds ratio (OR) 1.13, 95 % confidence interval (CI) 1.04 to1.23, p = 0.003), male gender (OR 4.07, 95 % CI 1.15 to 14.5, p = 0.030), HbA1c (OR 6.65, 95 % CI 1.21 to 36.5, p = 0.029) and FcγRIIIB-NaII/NaII (OR 3.94, 95 % CI 1.08 to 14.3, p = 0.037). In this long-term follow-up study of patients with ischemic stroke at a young age, FcγRIIIB-NaII/NaII was identified as a possible contributing factor for cIMT ≥1 mm together with known risk factors, such as age, male gender, systolic BP, additional arterial events and HbA1c.

Elevated hemoglobin A1c Is Associated with Carotid Plaque Vulnerability: Novel Findings from Magnetic Resonance Imaging Study in Hypertensive Stroke Patients

“…Using carotid ultrasound, Ulrike et al . showed that HbA1c was an independent risk factor for cIMT in long-term survivors of ischemic stroke 26 . Comparing with carotid ultrasound, MRI can accurately characterize plaque morphology and tissue composition of human carotid atherosclerotic plaque 27 .…”

IL-17A-Mediated Excessive Autophagy Aggravated Neuronal Ischemic Injuries via Src-PP2B-mTOR Pathway

“…As the leading cause of death, ischemic stroke (>80% of stroke) is a medical emergency with high morbidity and mortality (1,2). It causes multiple pathophysiological events including mitochondrial response, excitotoxicity, protein misfolding and immune response, which lead to the delayed neuronal loss (3).…”

Hemoglobin A1c as A Potential Indicator for Intraplaque Hemorrhage of Carotid Artery Atherosclerosis in Asymptomatic Adults

“…In this study, we found that the level of HbA1c was associated with carotid IPH, which was a primary characteristic of vulnerable plaques. Previous studies have identi ed the association between HbA1c and subclinical atherosclerosis, suggesting that HbA1c may be involved in the early stage of atherosclerosis (4,5,16,17). As the development of atherosclerosis, the rupture of vulnerable carotid plaques could result in ischemic stroke (1).…”