Characteristics of paramedian pontine arteries disease and its association with hemoglobinA1c

Li, Haiyan; Shu, Yaqing; Hu, Biao; Dai, Yongqiang; Lin, Yinyao; Shan, Yingchun; Wang, Yuge; Cai, Wei; Lu, Zhengqi

doi:10.1002/brb3.946

Cited by 4 publications

(8 citation statements)

References 28 publications

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“…Meanwhile, multinomial logistic regression analysis depicted that the fasting blood glucose (FBG) level was an independent risk factor for BAD. These results are consistent with previous studies showing that DM or HbA1c is associated with BAD, especially paramedian pontine arteries disease (33).…”

Section: Discussionsupporting

confidence: 93%

Twenty-four-hour ambulatory blood pressure variability and association with ischemic stroke subtypes in the subacute stage

et al. 2023

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Background and purposeBlood pressure (BP) variability (BPV) increases the risk of cerebral disease in both hemorrhagic and ischemic strokes. However, whether BPV is associated with different types of ischemic stroke remains unclear. In this study, we explored the relationship between BPV and ischemic stroke subtypes.MethodsWe enrolled consecutive patients aged 47–95 years with ischemic stroke in the subacute stage. We categorized them into four groups based on their artery atherosclerosis severity, brain magnetic resonance imaging markers, and disease history: large-artery atherosclerosis, branch atheromatous disease, small-vessel disease, and cardioembolic stroke. Twenty-four-hour ambulatory blood pressure monitoring was performed, and the mean systolic blood pressure/diastolic blood pressure, standard deviation, and coefficient of variation were calculated. A multiple logistic regression model and random forest were used to test the relationship between BP and BPV in the different types of ischemic stroke.ResultsA total of 286 patients, including 150 men (73.0 ± 12.3 years) and 136 women (77.8 ± 9.6 years) were included in the study. Of these, 86 (30.1%) patients had large-artery atherosclerosis, 76 (26.6%) had branch atheromatous disease, 82 (28.7%) had small-vessel disease, and 42 (14.7%) had cardioembolic stroke. There were statistically significant differences in BPV between subtypes of ischemic stroke in 24-h ambulatory blood pressure monitoring. The random forest model showed that BP and BPV were important features associated with ischemic stroke. Multinomial logistic regression analysis demonstrated that systolic blood pressure levels; systolic blood pressure variability at 24 h, daytime and nighttime; and nighttime diastolic blood pressure were independent risk factors for large-artery atherosclerosis after adjustment for confounders. When compared to branch atheromatous disease and small-vessel disease, nighttime diastolic blood pressure and standard deviation of diastolic blood pressure were significantly associated with patients in the cardioembolic stroke group. However, a similar statistical difference was not seen in patients with large-artery atherosclerosis.ConclusionThe results of this study indicate a discrepancy in blood pressure variability among different ischemic stroke subtypes during the subacute stage. Higher systolic blood pressure and systolic blood pressure variability during the 24 h, daytime, and nighttime, and nighttime diastolic blood pressure were independent predictors for large-artery atherosclerosis stroke. Increased nighttime diastolic BPV was an independent risk factor for cardioembolic stroke.

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Section: Discussionsupporting

confidence: 93%

Twenty-four-hour ambulatory blood pressure variability and association with ischemic stroke subtypes in the subacute stage

et al. 2023

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“…This is consistent with the findings of other studies showing that vascular risk factors are more commonly associated with BAD than with LAA. [12,13] This retrospective study had a small sample size, with many patients who met the exclusion criteria. In addition, since the results were from a single tertiary care hospital, it may not be generalizable.…”

Section: Discussionmentioning

confidence: 99%

“…[10,11] Several studies have provided evidence suggesting that the lesion extended to the basal surface of the pons because of atherosclerosis-associated BAD. [12,13] Cerebral and peripheral arterial diseases (PAD) share atherosclerosis as a common mechanism. PAD is broadly defined as stenosis or aneurysm of the aorta and its branch arteries but is generally defined as stenosis of the lower extremity arteries.…”

Section: Introductionmentioning

confidence: 99%

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An isolated pontine infarct extending to the basal pontine surface has a higher abnormal ankle-brachial index

Kim,

2023

Medicine

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Patients with ischemic stroke and branch atheromatous disease (BAD) have worse neurological deficits and prognoses than those with small vessel occlusion (SVO). However, both disorders are forms of deep brain infarctions. This study aimed to investigate an MRI-based etiological classification for isolated pontine infarctions and assess differences in vascular risk factors and peripheral arterial disease among etiological subtypes. Consecutive data of patients admitted for acute ischemic stroke or transient ischemic attack between August 2016 and July 2019 were reviewed. Acute isolated pontine infarcts were classified into 3 groups: BAD, SVO, and large-artery atherosclerosis (LAA), according to basilar or vertebral artery steno-occlusion and the extent of the infarct lesion on the basal pontine surface as displayed on magnetic resonance imaging and angiography. Vascular risk factors, ankle-brachial index (ABI), and brachial-ankle pulse wave velocity were analyzed in the 3 groups. Among 64 enrolled patients, BAD was the most common cause of isolated pontine infarct. The BAD group had a higher frequency of abnormal ABI and hypertension than the SVO group. The BAD group had abnormal ABI and hyperlipidemia more frequently than the LAA group. No significant difference was found in diabetes or brachial-ankle pulse wave velocity incidence between the BAD and SVO groups. ABI and vascular risk factors in the BAD group were more similar to those in the LAA group than to those in the SVD group. This finding suggests that pontine lesions extending to the basal pontine surface have an atherosclerotic mechanism in BAD, requiring potent antiplatelet therapy for the secondary prevention of ischemic stroke.

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“…Diabetes was associated more with SVO. Li et al found that patients with pontine infarction caused by SVO were more likely to have diabetes than those with SVO-induced nonpontine infarction in the anterior circulation [ 18 ]. Thus, we performed a further subgroup analysis of patients with SVO.…”

Section: Discussionmentioning

confidence: 99%

Higher Prevalence of Diabetes in Pontine Infarction than in Other Posterior Circulation Strokes

Zhu

Wang

et al. 2022

Journal of Diabetes Research

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Background. Pontine infarction is the major subtype of posterior circulation stroke, and diabetes is more common in pontine infarction patients than in anterior circulation stroke patients. Whether the prevalence of diabetes remains homogenous within the posterior circulation stroke population is unclear. The present study is aimed at investigating the prevalence of diabetes in pontine infarction and comparing it to other subtypes of posterior circulation stroke. Methods. We conducted a multicenter case-control study. Patients with posterior circulation stroke were screened. The subjects were divided into pontine infarction and nonpontine infarction groups. Results. From November 1, 2018, to February 28, 2021, a total of 6145 stroke patients were screened and 2627 patients had posterior circulation strokes. After excluding cardioembolic stroke, as well as its other determined and undetermined causes, 1549 patients with 754 pontine infarctions were included in the analysis. The prevalence of diabetes in the pontine infarction group was higher than that in the nonpontine infarction group (42.7% vs. 31.4%, P < 0.05 ). After adjusting for confounding factors, diabetes was an independent risk factor for pontine infarction (OR 1.63, 95% CI 1.27-2.09, P < 0.05 ). For small vessel occlusion, diabetes was also more common in the pontine infarction group (43.2% vs. 30.0%, P < 0.05 ). Multivariate analysis also showed that diabetes was an independent risk factor for pontine infarction (OR 1.80, 95% CI 1.32-2.46, P < 0.05 ). Conclusion. In comparison with the nonpontine infarction subtype of posterior circulation stroke, patients with pontine infarction had a higher prevalence of diabetes, and diabetes was an independent risk factor for pontine infarction.

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Characteristics of paramedian pontine arteries disease and its association with hemoglobinA1c

Cited by 4 publications

References 28 publications

Twenty-four-hour ambulatory blood pressure variability and association with ischemic stroke subtypes in the subacute stage

Twenty-four-hour ambulatory blood pressure variability and association with ischemic stroke subtypes in the subacute stage

An isolated pontine infarct extending to the basal pontine surface has a higher abnormal ankle-brachial index

Higher Prevalence of Diabetes in Pontine Infarction than in Other Posterior Circulation Strokes

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