London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 459 329 Etiology of stroke and risk factors HEMOSTASIS GENES’ CONDITION IN YOUNG SLAVIC PATIENTS WITH ISCHEMIC STROKE V.V. Gusev1, O.A. Lvova2, A.M. Alasheev3, A.A. Charushnikova4, A.V. Mamonova5, S.A. Savin6, M.Y. Abilova7 City Clinic Hospital 23, Yekaterinburg, RUSSIAN FEDERATION1, Ural State Medical Acad-emy, Yekaterinburg, RUSSIAN FEDERATION2, Regional Clinic Hospital 1, Yekaterinburg, RUS-SIAN FEDERATION3, Ural State Medical Academy, Yekaterinburg, RUSSIAN FEDERATION4, Regional Clinic Hospital 1, Yekaterinburg, RUSSIAN FEDERATION5, Ural State Medical Acade-my, Yekaterinburg, RUSSIAN FEDERATION6, Ural State Medical Academy, Yekaterinburg, RUS-SIAN FEDERATION7 Background. Inherited thrombophilia is described as a risk factor for the first AIS in young. Ev-ery new trial brings us informative, but contradictive data. The role of each polymorphic gene and their combinations are not investigated thoroughly. Methods. Case-control study. 31 patients’ blood samples (13 male and 18 female) with AIS were compared with 99 controls. 8 single nucleotide polymorphisms (SNPs) by polymerase chain reaction we identified. Inclusion criteria: age 18-45 y.o.; slavic origin; AIS confirmed by brain CT scan and spinal tap. Results. The average age for the first AIS was 34,5 y.o. We identified risk factors: heart diseases - 25 (80,6%), arterial hypertension -19 (61,3%), smoking – 22 (70,9%), undifferentiated connective tissue dysplasia symptoms – 13 (41,9%), diabetes mellitus – 3 (9,7%). There were the 1st and 2nd line relatives with thrombosis in 67,7% (n=21) their family history. Nobody was determined as having thrombophilia before the stroke occured. All patients carried genes of thrombophilia: 4 people had two SNPs; 10 – three; 13 – four; 3 – five; 1 had six SNPs. We identified SNPs in the homozygous or heterozygous state: F2: G20210А 1vs3 (OR=1,06 95%CI 0,1-11,1), F5: G1691A 2vs1 (OR=6,76 95%CI 0,6-81,1), F7: G 10976A 9vs11 (OR=3,27 95%CI 1,2-9,1), F13: G103T 23vs49 (OR=2,93 95%CI 1,2-7,3), PAI-1: -675 5G/4G 25vs83 (OR=0,8 95%CI 0,3-2,3), FGB: G-455A 18vs37 (OR=2,32 95%CI 1,0-5,3), ITGA2: С807Т 26vs65 (OR=2,72 95%CI 0,9-7,9), ITGB3: Т1565C 8vs40 (OR=0,51 95%CI 0,2- 1,3). Our patients had particular SNP’s combination (see table), most often including polymorphic genes of fibrinogen (FGB), platelets receptors (ITGA) and fibrinolytic system (PAI). Conclusion. Thrombophilia is not the only cause of stroke in young patients. We assume multigene combina-tions, especially three and more SNPs, as well as “sticky platelets” syndrome with defective fibri-nolytic system, have the most diagnostic value in young slavic stroke patients. Stroke in young re-mains multifactorial disease but thrombophilia will become “the last straw” if all another risk factors are not prevented. Table Polymorphic genes’ combination in young slavic patients with AIS and controls SNPs’ combinations Cases Controls OR 95%CI FGB: G-455A + ITGB3: Т1565C 4 19 0,62 0,2-2,0 FGB: G-455A + F13: G103T 13 22 2,52 1,1-6,1 FGB: G-455A + PAI-1: -675 5G/4G 13 32 1,51 0,6-3,5 ITGA2: С807Т + PAI-1: -675 4G4G 13 15 4,04 1,6-10,1 FGB: G-455A + ITGA2: С807Т + PAI-1: -675 5G/4G 11 17 2,65 1,1-6,7 FGB: G-455A + ITGA2: С807Т + F13: G103T + PAI-1: -675 5G/4G 8 9 3,48 1,2-10,2 330 Etiology of stroke and risk factors Atherosclerosis of carotid artery in patients with cryptogenic ischemic stroke: carotid duplex ultrasonography study H. PARK1, A. CHO2, S. KIM3, W. KIM4, B. KIM5 Department of Neurology, Catholic University of Korea, College of Medicine, Seoul St.Mary’s Hospital, Seoul, SOUTH KOREA1, Department of Neurology, Catholic University of Korea, Col-lege of Medicine, YeouidoSt.Mary’s Hospital, Seoul, SOUTH KOREA2, Department of Neurology, Catholic University of Korea, College of Medicine, YeouidoSt.Mary’s Hospital, Seoul, SOUTH KOREA3, Department of Neurology, Catholic University of Korea, College of Medicine, YeouidoSt. Mary’s Hospital, Seoul, SOUTH KOREA4, Department of Neurology, Catholic University of Korea, College of Medicine, YeouidoSt.Mary’s Hospital, Seoul, SOUTH KOREA5 Background: Up to 40% of ischemic stroke patients have negative results in their stroke etiologic workups, being classified as a cryptogenic stroke. CT or MR angiography may miss mild atheroscle-rotic change and is insufficient in evaluating the vulnerability of plaque. In this study, we investigat-ed carotid arteries using carotid duplex ultrasonography to identify atherosclerotic change in cryp-togenic ischemic stroke patients. Methods: We enrolled patients with cryptogenic ischemic stroke according to the TOAST classification. Carotid duplex ultrasonography was routinely performed as a part of stroke workups. We obtained data about demographics, classical stroke risk factors, duplex ultrasonography and brain imaging. Duplex ultrasonography was performed by General Electron-ics, LOGIQ 7.0 to exam intima-media thickness(IMT) and the character of carotid plaque. CT or MR angiography of patients were reviewed to check intracranial and extracranial vessels. Results: A total of 42 cryptogenic stroke patients were enrolled. The mean age was 58.21±14.2(SD), 25 were male. 22(52.4%) patients had carotid plaque. Plaque thickness(mean, SD) was 2.9±1.1(mm, range 1.6 ~5.3). The average of IMT increased in 7 patients. Carotid plaque which was located in the par-ent artery to the index stroke was observed in 18 patients(42.9%). Plaque natures of them were echogenic or isoechoic(n=9), mixed heterogenous(n=2), echolucent(n=2), and unknown(n=1). The presence of carotid plaque was significantly associated with the presence of hyperlipidemia(14/22 vs 6/20, p=0.029). The CT angiographic findings were normal in 14 patients, among them 11 patients had plaque. Conclusion: In 42.9% of cryptogenic acute ischemic stroke patients, carotid atheroscle-rotic plaques in their relevant parent arteries were observed. Hyperlipidemia was associated with the plaque. The assessment of carotid artery with ultrasonography might be useful in identifying coex-isting atherosclerosis in cryptogenic stroke.
Karger_ESC London_2013
To see the actual publication please follow the link above