Inflammatory markers and conventional atherosclerotic risk factors in acute ischemic stroke: comparative study between vascular disease subtypes.

ABSTRACT

BACKGROUND: Large vessel atherosclerosis and small vessel disease are two major causes of ischemic stroke. In patients with large vessel disease, the lesions can be located in the extracranial carotid or intracranial arteries. OBJECTIVE: To search for the differences of risk factors and inflammatory markers among patients with each subtype of vascular disease. MATERIAL AND METHOD: Patients with acute ischemic stroke who had large vessel atherosclerosis or small vessel disease were studied. Patients with large vessel atherosclerosis were subdivided into extracranial carotid and intracranial stenosis groups. Blood samples were collected for c-reactive protein, erythrocyte sedimentation rate, hemoglobin A1C fibrinogen, fasting plasma glucose, cholesterol, triglyceride, and low-density and high-density lipoproteins. Risk factors and results of the blood tests between the groups of patients were compared. RESULTS: There were 116 patients in the study. Sixty-three patients had large vessel disease, whereas 53 patients had small vessel disease. More prevalence of diabetes and higher c-reactive protein were significantly found in patients with large vessel disease. C-reactive protein on admission was also higher in patients with extracranial carotid stenosis than those with intracranial stenosis. Serum cholesterol and low-density lipoprotein was significantly higher in patients with intracranial stenosis than those with small vessel extracranial disease. CONCLUSION: Diabetes and higher c-reactive protein on admission were associated with large vessel disease. c-reactive protein was also higher in patients with extracranial carotid stenosis but their cholesterol and low-density lipoprotein were significantly lower than those with intracranial disease.