Highlights
- •73 Intracranial atherosclerotic disease first-ever stroke patients were studied.
- •Presence of new CVEs was assessed every six months.
- •Ankle-brachial index (ABI) and PAI-1 independently predict further strokes.
- •Discrimination power of ABI and ESRS improve in combination with PAI-1.
Abstract
Background and purpose
We prospectively examine the single and combined predictive value of biological and
clinical markers in recurrent strokes related to intracranial atherosclerotic disease
(ICAD).
Methods
In 73 ICAD first-ever stroke patients, ankle-brachial index (ABI) was assessed three
months after TIA or stroke together with CRP, Lp-PLA2, ICAM-1, E-selectin and PAI-1
measurements. Appearance of new TIA/stroke was assessed every 6 months.
Results
After a median follow-up of 22.4 months, 13 patients (17.8%) suffered a new stroke
or TIA. Risk of new cerebrovascular events (CVEs) was associated with lowered ABI
(p=0.011), baseline PAI-1>22.52 ng/ml (<0.001), E-selectin>24.75 ng/ml (p=0.008) and ICAM-1>205 ng/ml (p=0.029). The combination of PAI-1 with ABI or ESRS reclassified 55.4% (p<0.005) and 48.3% (p<0.05) of patients between low, high and very high-risk categories.
Conclusions
This tentative study shows that ABI and PAI-1 are associated with the risk of new
CVEs in symptomatic ICAD patients, and their combination might improve identification
of patients at higher risk.
Keywords
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Article info
Publication history
Accepted:
December 24,
2013
Received in revised form:
December 14,
2013
Received:
September 17,
2013
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
