Genetically Predicted Coffee Consumption and Risk of Alzheimer's Disease and Stroke.

BACKGROUND: Observational studies have reported that coffee consumption was associated with Alzheimer's disease (AD) and stroke risk. However, the results are inconclusive. OBJECTIVE: We aimed to evaluate whether genetically predicted coffee consumption is associated with AD and stroke using Mendelian randomization (MR) design. METHODS: Summary-level data for AD (n = 54,162), ischemic stroke (n = 440,328), and intracerebral hemorrhage (ICH, n = 3,026) were adopted from publicly available databases. Summary-level data for coffee consumption were obtained from two genome-wide association studies, comprising up to 375,833 subjects. RESULTS: Genetically predicted coffee consumption (cups/day) was associated with an increased risk of AD (OR = 1.26, 95%CI = 1.05-1.51). Moreover, genetically predicted 50%increase of coffee consumption was associated with an increased risk of ICH (OR: 2.27, 95%CI: 1.08-4.78) but a decreased risk of small vessel stroke (OR: 0.71, 95%CI: 0.51-0.996). Estimate for AD and ICH in FinnGen consortium is directionally consistent. Combined analysis of different databases further confirmed that genetically predicted coffee consumption was associated with an increased risk of AD and ICH. In the multivariable MR analysis, genetically predicted coffee consumption retained a stable effect with AD and ICH when adjusting for smoking (p < 0.05), while the association with AD attenuated when adjusting for alcohol use. CONCLUSION: Our results indicate that genetically predicted coffee consumption may be associated with an increased risk of AD and ICH. The underlying biological mechanisms warrant further study.

Infarct morphology assessment in patients with carotid artery/middle cerebral artery occlusion using fast fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH).

We aim to evaluate the value of fast fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) in assessing infarct morphology in patients with symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusions. Magnetic resonance (MR) diffusion-weighted imaging (DWI) FLAIR sequences, and carotid/cerebral magnetic resonance angiography of 102 patients with symptomatic ICA or MCA occlusions were evaluated. The location and score of FVH were determined using Olindo's method; patients were classified as having Low or High FVHs based on FVH score, and either Distal or Proximal FVH based on FVH location. The differences between infarct morphologies were analyzed. FVH were detectable in 62 patients with High FVH and in 40 patients with Low FVHs based on the Olindo's scale. There were no statistically significant differences in age, gender, hypertension, diabetes, hyperlipidemia, smoking history, and vascular occlusive site between High and Low FVHs patients, except for infarct morphology (P<0.01). Patients with Distal FVH presented with significant (P<0.01) perforating artery and border zone infarcts, whereas those with Proximal FVH had significant (P<0.01) large territorial infarcts. The scores and locations of FVH could be a predictive imaging marker for infarct morphology in patients with symptomatic ICA or MCA occlusion.

[Effects of metabolic syndrome on multi-vessel lesions of symptomatic intracranial atherosclerosis].

OBJECTIVE: To explore the effects of metabolic syndrome (MS) on multi-vessel lesions of symptomatic intracranial atherosclerosis. METHODS: During April 2009 and October 2010, a total of 139 consecutive hospitalized patients with symptomatic intracranial atherosclerosis were recruited to undergo magnetic resonance angiography (MRA) or/and CT angiography (CTA) or/and digital subtraction angiography (DSA) to measure the stenotic degree and numbers of intracranial atherosclerosis. They were divided into 2 groups according to lesion numbers: single and multi-vessel lesions. MS was defined by the criteria of the Adult Treatment Panel III to examine the incidences of MS. The risk factors were analyzed for multi-vessel lesions of symptomatic intracranial atherosclerosis to explore the relationship between MS and multi-vessel lesions. RESULTS: Among them, 210 intracranial atherosclerotic lesions were documented. Fifty-nine (42.4%) patients had two or more lesions (group with multi-vessel lesions). The incidence of MS was 70.5%. The rates of MS in groups of single and multi-vessel lesions were 56.3% and 89.8% respectively. And statistical significance existed between two groups (P < 0.001). Moreover, the number of MS components increased gradually with the number of lesions (P < 0.001). For the analysis of individual criteria for MS, only abnormal glycemia was found to be associated with multi-vessel lesions (P = 0.002). And multiple Logistic regression analysis showed that MS was associated with multi-vessel lesions of intracranial atherosclerosis (P = 0.001). CONCLUSIONS: MS is an independent predictor for multi-vessel lesions of intracranial atherosclerosis. And its intervention may be an important preventive strategy for intracranial multi-vessel atherosclerosis.

[Predictors of Wingspan in-stent restenosis for the treatment of symptomatic intracranial arterial stenosis].

OBJECTIVE: To analyze the predictors of Wingspan in-stent restenosis (ISR) for the treatment of symptomatic intracranial arterial stenosis. METHODS: Between January 2007 and November 2009, 42 patients with symptomatic intracranial arterial stenosis registered in Nanjing stroke registry program (NSRP) were treated with Wingspan stent system. Clinical and follow-up results were retrospectively analyzed. They were divided into the non-restenosis and restenosis groups according to their follow-up imaging data. ISR was defined as > 50% stenosis within 5 mm or adjacent to stent or an absolute luminal loss > 20%. The analysis of stepwise multivariate Cox regression was performed to evaluate the independent predictive factors. RESULTS: ISR was found in 15 patients (15/42, 35.7%) with 16 lesions (16/43, 37.2%) at a median follow-up period of 7 months (range: 4 - 23). Diabetes (HR = 0.281; 95%CI = 0.088 - 0.898; P = 0.032) and stent diameter (HR = 0.213; 95%CI = 0.049 - 0.918; P = 0.038) were two independent predictors for ISR. CONCLUSION: Diabetes and stent diameter may be two independent predictors for ISR after a treatment of Wingspan system.

[Effect of lesion length on in-stent restenosis after intracranial stenting].

OBJECTIVE: To evaluate the effect of lesion length on in-stent restenosis (ISR) after intracranial stenting. METHODS: Between March 2004 and September 2009, 65 patients with symptomatic intracranial arterial stenosis were successfully implanted with single bare metal balloon-mounted stent. All received a conventional angiographic follow-up. The patients were divided into three groups according to lesion length: short lesions (< 5 mm), medium lesions (5-10 mm) and long lesions (> 10 mm). ISR was defined as > 50% stenosis within stent or absolute luminal loss > 20%. The influence of different lesion lengths on ISR was evaluated. Furthermore, the independent predictive factors for ISR were selected. RESULTS: There were short lesions (n = 28), medium lesions (n = 29) and long lesions (n = 8). The median interval of angiographic follow-up was 7 months with a range of 5-30 months. Of 65 patients, 19 (29.2%) had ISR. The ISR rates were 14.3%, 37.9% and 50% in short lesions, medium lesions and long lesions respectively (P = 0.045). Multivariate Cox regression analysis showed that lesion length (HR = 1.210; 95%CI = 1.011-1.446; P = 0.037) and diabetes (HR = 2.630; 95%CI = 1.032-6.705; P = 0.043) were associated with ISR. CONCLUSION: Lesion length and diabetes are two independent predictors for ISR after intracranial stenting.