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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ischaemic stroke ranks among the most important causes of death and disability in developed countries. Abnormal lipid metabolism is among the several factors that have a role in the pathogenesis of atherosclerosis. We hypothesize that the decreased resistance of low-density lipoproteins against oxidative stress is an independent risk factor for cerebral atherosclerosis and suggest testing this hypothesis by ultrasonographic evaluation of the carotid artery and correlating this finding to plasma values of compounds that play a role in lipid metabolism. By measuring the oxidative resistance of low-density of lipoprotein the risk for ischaemic stroke can be predicted.
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PMID:A possible role of decreased oxidative resistance of low-density lipoproteins in the early formation of carotid atherosclerosis. 1139 20

One of the important mechanisms involved in the development of vascular lesions leading to ischemic stroke could be an immune response to heat shock proteins (hsp). For carotid atherosclerosis and myocardial infarction, an association with an increase in anti-hsp 65 antibodies has been demonstrated. The aim of our study was (1) to investigate whether ischemic stroke is associated with a humoral immune response to hsp; (2) to study the connection between anti-hsp antibodies and other stroke risk factors; (3) to estimate if the elevated levels of anti-hsp antibodies could be an independent risk factor for stroke. We examined 180 patients (in the first 48 h after stroke onset) and 64 age-matched healthy controls. The levels of IgG and IgM antibodies to hsp 65 and 70 were measured by ELISA. Ischemic stroke was connected with a significant elevation of anti-hsp 65 and anti-hsp 70 antibody levels (IgG and IgM) compared with controls (p < 0.0001). The multifactorial logistic regression analysis showed that increased levels of anti-hsp 65 and anti-hsp 70 IgG antibodies are independent risk factors for stroke. Our results suggest that humoral immunity to hsp is common in stroke patients and that elevated levels of anti-hsp antibodies could be triggering factors for stroke.
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PMID:Elevated levels of anti-heat shock protein antibodies in patients with cerebral ischemia. 1164 89

Ischaemic stroke subtypes in children and adults were compared to determine the similarity in aetiologies. Thirty-six children (22 females, 14 males; median age 5 years 7 months, range 6 weeks to 15 years 10 months) and 50 adults (35 males, 15 females; median age 44 years, range 17 years 2 months to 49 years 11 months) who had presented with ischaemic stroke between 1995 and 2000, were categorized using a modified version of the Trial of Org 10172 in Acute Stroke Therapy (TOAST) classification. Proportions of patients in the subtypes of the TOAST classification system were significantly different in the two groups (chi2 test, p<0.01). The first three subtypes (large artery atherosclerosis, cardioembolic, and small vessel disease) accounted for the majority of adult strokes (27 of 50). In contrast, only three of 36 children were accounted for within these three subtypes. The majority of children (29 of 36) were classified within the 'other determined aetiology' subtype. Aetiology was undetermined in 12 of 50 adults compared with three of 36 children. Causes of ischaemic stroke in children and adults are distinct. A classification system for ischaemic stroke in children would be useful for collaborative studies.
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PMID:Ischaemic stroke subtypes in children and adults. 1264 23

Ischaemic stroke is the most common form of stroke and is caused by atherosclerosis in most patients. Several genetic determinants contribute to stroke risk. Of these, carotid intimal-medial wall thickness (IMT) is particularly relevant, because it is a surrogate measure of subclinical atherosclerosis and a strong predictor of future ischaemic stroke. Studies of twins, siblings, and families have provided significant evidence for heritability, but the genes involved have not been identified. Some researchers have reported that IMT is high in people with functional variants of genes related to matrix deposition (MMP3), inflammation (interleukin 6), and lipid metabolism (hepatic lipase, APOE, CETP, and PON1). In this review, we assess the robustness of these associations and examine whether there is any evidence of risk modification by factors, such as smoking.
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PMID:Genetic risk factors for stroke and carotid atherosclerosis: insights into pathophysiology from candidate gene approaches. 1503 35

Ischemic stroke is a complex entity with multiple etiologies and variable clinical manifestations. The most frequent cause of stroke is atherosclerosis of cerebral vasculature followed by cardioembolism. Two thirds of strokes are explained by identifiable risk factors. Age, hypertension, and nonvalvular atrial fibrillation are by far the most frequent and well documented ones. Approximately 5% of strokes are caused by conditions other than atherosclerosis or heart disease, i.e., cervical arteries dissections, nonatherosclerotic vasculopathies, infectious or systemic vasculitis, and collagen vascular diseases. In spite of a thorough diagnostic evaluation, 30% of strokes remain cryptogenic, i.e., no specific cause is identified and the classic risk factors are not present. Identification of unknown environmental or genetic risk factors should be the subject of further research.
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PMID:What proportion of stroke is not explained by classic risk factors? 1572 93

The black Caribbean population continues to grow in the US and little is known about stroke etiologies in that community. We examined stroke subtypes in 175 consecutive Haitian-born patients living in Miami, admitted for acute stroke. Ischemic stroke was diagnosed in 72%. Small vessel occlusion was the most frequent stroke subtype. There was a high prevalence of hypertension, medication noncompliance and intracranial atherosclerosis. Hypertension was the only cardiovascular risk factor significantly associated with small vessel infarction when compared with non-small vessel infarcts.
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PMID:Stroke etiology among Haitians living in Miami. 1610 30

Ischemic stroke is composed of subtypes with variable underlying pathogenesis and studies on ischemic stroke as a whole may inadequately evaluate risk factors, being influenced by subtype distribution among studied population. This study aimed to evaluate risk factors associated with individual ischemic stroke subtypes defined by the Trial of ORG10172 in Acute Stroke Treatment. In a case-control study (290 first-ever ischemic stroke cases and 1160 individually matched controls without stroke) nested within Korean male public servants cohort, a range of potential risk factors measured at periodic health surveys prior to the onset of stroke event were examined using conditional logistic regression analysis. Increased risk for large-artery atherosclerosis was associated with hypercholesterolemia (> or = 6.2 mmol/L), hypertension, and smoking. Increased risk for small-artery occlusion was associated with hypertension, hyperglycemia (> or = 7.0 mmol/L), and frequent alcohol intake. No specific risk factor was identified for cardioembolism. For combined ischemic stroke, hypercholesterolemia, hyperglycemia, hypertension, and smoking were associated with the increased risk, but the relative odds were much smaller than those estimated from subtype analysis. Significance of risk factors evaluated for subtypes, rather than ischemic stroke as a whole, should be reflected in preventive efforts against the burden of ischemic stroke.
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PMID:Different risk factor profiles between subtypes of ischemic stroke. A case-control study in Korean men. 1611 34

This observational prospective multicentre study aims to describe a hospital-based database collecting information about clinical features, management and follow-up of stroke patients. In 18 neurological departments (mostly first-referral) in Piedmont and the Aosta Valley, Italy, between May and July 1999, 604 consecutive patients (97 TIA, 443 ischaemic, and 64 haemorrhagic stroke) were studied. Ischaemic stroke aetiologies were as follows: large-artery atherosclerosis (148), small-artery occlusion (133), cardioembolism (76), other causes (13) and undetermined (73). According to Bamford's classification, 164 were PACI, 126 LACI, 87 TACI and 66 POCI. The diagnostic workup and management of patients is described; only 4% of patients did not receive a CT scan. Four hundred and three patients were discharged to their home, 78 to a rehabilitation unit, 44 to long-term institutional care, 20 to other wards and 59 died while in hospital. After six months, 10 patients were lost to follow-up, 499 were alive and 95 had died. The SINPAC database allows for evaluation of current practice of care in a first-referral stroke population.
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PMID:Stroke and transient ischaemic attack in 18 neurology departments from two Italian Regions: the SINPAC database. 1619 47

Stroke represents a major health burden in our country. Ischaemic stroke has got several risk factors associated with increased chance of atherosclerosis. A small hospital-based study was done to look into the risk factors associated with ischaemic stroke. Forty patients with CT-confirmed cerebral infarction were taken for the study and detailed history and clinical findings were obtained. Investigations like complete haemogram, fasting blood glucose, urea, creatinine, lipid profile, serum Lp(a), homocysteine, fibrinogen, ECG, chest x-ray, echocardiography, MRI/MRA where indicated, were done to identify the risk factors as well. Results indicated that hypertension was the most prevalent (87.5%) risk factor followed by ischaemic heart disease (35%) and diabetes. Dyslipidaemia was also found in a significant number of cases, mostly elevated LDL, low HDL and elevated Lp(a). Fibrinogen and homocysteine were of less significance.
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PMID:Risk factor analysis in ischaemic stroke: a hospital-based study. 1657 Jul 59

Ischaemic stroke due to intracranial atherosclerosis is estimated to comprise 8-12% of all ischaemic strokes. It is known that the risk of recurrence is extremely high in patients with ischaemic stroke caused by intracranial stenosis. In the present study we aimed to evaluate the clinical and radiological findings over a 6-month follow-up period in patients with intracranial atherosclerosis. Prospective data for the ischaemic stroke patients admitted to our clinic between 2001 and 2004 were collected. The localization of stenosis/occlusion detected by magnetic resonance angiography (MRA) was recorded and patients were divided into two groups according to the presence of one or more arterial stenoses on MRA. The patients were followed up for 6 months at regular intervals and stroke recurrence and deaths were noted. Of the 47 patients, 11 had posterior circulation stenosis and 36 had anterior circulation stenosis. Thirty-three patients had only one intracranial artery stenosis, whereas 14 had more than one intracranial artery stenosis. Of the 38 patients who completed the 6-month follow-up period, 13 had recurrent stroke, and 10 died. The rate of stroke recurrence in patients with intracranial artery stenosis may be higher than in patients with stroke due to other aetiologies, and stenosis of multiple intracranial arteries increases the rate of recurrence.
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PMID:Six-month follow-up study in patients with symptomatic intracranial arterial stenosis. 1704 46


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