ABSTRACT
Ischemic stroke is a disease with high incidence, high disability and high mortality rates. As a key regulator of microglia activation and proliferation, galectin-3 may have dual effects on ischemic stroke. This article reviews the structure and function of galectin-3, as well as its roles in ischemic stroke.
ABSTRACT
The pathophysiology of ischemic stroke involves the vascular neural network. Cerebral vein is an indispensable part of vascular neural network, which can provide effective drainage pathway and maintain sufficient cerebral perfusion. More and more evidence have shown that the normal function of cerebral venous drainage system may be as important as arterial perfusion for the outcome of patients with ischemic stroke. However, compared with the cerebral artery system, the cerebral venous system has not attracted enough attention. This article reviews the anatomy of cerebral venous system, the imaging changes after ischemic stroke, and the possible mechanisms of cerebral venous system involved in ischemic stroke and its related complications.
ABSTRACT
BACKGROUND@#High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease. We explored a predictive model of platelet reactivity to clopidogrel and the relationship with clinical outcomes.@*METHODS@#A total of 441 patients were included. Platelet reactivity was measured by light transmittance aggregometry after receiving dual antiplatelet therapy. HTPR was defined by the consensus cutoff of maximal platelet aggregation >46% by light transmittance aggregometry. CYP2C19 loss-of-function polymorphisms were identified by DNA microarray analysis. The data were compared by binary logistic regression to find the risk factors. The primary endpoint was major adverse clinical events (MACEs), and patients were followed for a median time of 29 months. Survival curves were constructed with Kaplan-Meier estimates and compared by log-rank tests between the patients with HTPR and non-HTPR.@*RESULTS@#The rate of HTPR was 17.2%. Logistic regression identified the following predictors of HTPR: age, therapy regimen, body mass index, diabetes history, CYP2C192, or CYP2C193 variant. The area under the curve of receiver operating characteristic for the HTPR predictive model was 0.793 (95% confidence interval: 0.738-0.848). Kaplan-Meier analysis showed that patients with HTPR had a higher incidence of MACE than those with non-HTPR (21.1% vs. 9.9%; χ = 7.572, P = 0.010).@*CONCLUSIONS@#Our results suggest that advanced age, higher body mass index, treatment with regular dual antiplatelet therapy, diabetes, and CYP2C192 or CYP2C193 carriers are significantly associated with HTPR to clopidogrel. The predictive model of HTPR has useful discrimination and good calibration and may predict long-term MACE.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Blood Platelets , Clopidogrel , Pharmacology , Therapeutic Uses , Coronary Artery Disease , Metabolism , Cytochrome P-450 CYP2C19 , Metabolism , Genotype , Glycated Hemoglobin , Metabolism , Kaplan-Meier Estimate , Logistic Models , Multivariate Analysis , Myocardial Ischemia , Metabolism , Regression AnalysisABSTRACT
Background:@#High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease. We explored a predictive model of platelet reactivity to clopidogrel and the relationship with clinical outcomes.@*Methods:@#A total of 441 patients were included. Platelet reactivity was measured by light transmittance aggregometry after receiving dual antiplatelet therapy. HTPR was defined by the consensus cutoff of maximal platelet aggregation >46% by light transmittance aggregometry. CYP2C19 loss-of-function polymorphisms were identified by DNA microarray analysis. The data were compared by binary logistic regression to find the risk factors. The primary endpoint was major adverse clinical events (MACEs), and patients were followed for a median time of 29 months. Survival curves were constructed with Kaplan-Meier estimates and compared by logrank tests between the patients with HTPR and non-HTPR.@*Results:@#The rate of HTPR was 17.2%. Logistic regression identified the following predictors of HTPR: age, therapy regimen, body mass index, diabetes history, CYP2C19*2, or CYP2C19*3 variant. The area under the curve of receiver operating characteristic for the HTPR predictive model was 0.793 (95% confidence interval: 0.738–0.848). Kaplan-Meier analysis showed that patients with HTPR had a higher incidence of MACE than those with non-HTPR (21.1% vs. 9.9%; χ2 = 7.572, P = 0.010).@*Conclusions:@#Our results suggest that advanced age, higher body mass index, treatment with regular dual antiplatelet therapy, diabetes, and CYP2C19*2 or CYP2C19*3 carriers are significantly associated with HTPR to clopidogrel. The predictive model of HTPR has useful discrimination and good calibration and may predict long-term MACE.
ABSTRACT
Angiogenesis is an important pathophysiological process of body response after cerebral ischemia.Angiogenesis is activated in a few hours after cerebral ischemia.It can promote neuronal remodeling and neurological function recovery.Studies have shown that the microvessel density is positively correlated with the long-term survival rate in patients with stroke after cerebral ischemia.This article reviews the regulatory mechanisms and imaging evaluation of angiogenesis after cerebral ischemia.