London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 759 781 Stroke prevention Plaque Morphology and Biomarkers of Carotid Atherosclerosis L.N. Maksyutkina1, A.A. Shabalina2, M.B. Kostyreva3, S.Y. Petrukhina4, A.A. Raskurazhev5, O.V. Lagoda6, M.M. Tanashyan7 Research Center of Neurology, Moscow, RUSSIAN FEDERATION1, Research Center of Neu-rology, Moscow, RUSSIAN FEDERATION2, Research Center of Neurology, Moscow, RUSSIAN FEDERATION3, Research Center of Neurology, Moscow, RUSSIAN FEDERATION4, Research Center of Neurology, Moscow, RUSSIAN FEDERATION5, Research Center of Neurology, Moscow, RUSSIAN FEDERATION6, Research Center of Neurology, Moscow, RUSSIAN FEDERATION7 BACKGROUND: Establishing markers of atherosclerotic plaque (AP) instability may enhance stroke prevention. A correlation between the levels of atherosclerotic and arterial wall inflammation biomarkers: lipoproteid-associated phospholipase А2 (Lp-PLА2), tumor necrosis factor alpha (TNF- α), neopterin – with the structure of AP in the internal carotid artery (ICA) was studied. METHODS: A total of 68 patients (48 – men, mean age – 65 (47;80)) with ICA atherosclerosis (AS) (>50% ste-nosis) verified by duplex ultrasonography DU (Philips iu2), as well as AP morphology (in case of carotid endarterectomy) were included. According to AP morphology all patient were divided into 2 groups: I – instable APs (33,4%), II – stable APs (66,6%) . Serum levels of the studied biomarkers were measured on Perkin Elmer Victor2 Reader (ELISA). Control group comprised same measure-ments in 20 people without ICA AS, matched by sex and age. RESULTS: Patients with instable APs had significantly higher levels of Lp-PLА2 compared to control (351,5±63 ng/ml vs. 210±43 ng/ ml p=0,044); TNF-α – 38,3±12,3 ng/ml, neopterin – 26,5±8,6 nmol/l. In the II group the results were as follows: Lp-PLА2 - 291±66,9 ng/ml, TNF-α – 27,5±7,8 ng/ml, neopterin – 21,6±6,7 nmol/l. When comparing DU results and AP morphology it was found that in hypoechogenic APs (instable) atheromatosis, necrosis and recent AP hemorrhages prevail, while in hyperechogenic APs (stable) – calcinosis, fibrosis, organized hemorrhages dominate. CONCLUSIONS: Found relationships be-tween AP instability in ICA (according to DU and morphology) and higher levels of Lp-PLА2 may suggest using this marker as a predictor of AS progression and the development of cerebrovascular events. 782 Stroke prevention Rate of Atrial fibrillation and Oral Anticoagulant Treatment in 55,562 Ischaemic Stroke pa-tients. Data from a Danish Nationwide Registry from 2003-2011 L. M. Christensen1, S. Funder2, H. K. Christensen3 Bispebjerg Hospital, University Hospital of Copenhagen, Dept. of Neurology, Copenhagen, DENMARK1, Bispebjerg Hospital, University Hospital of Copenhagen, Dept. of Neurology, Co-penhagen, DENMARK2, Bispebjerg Hospital, University Hospital of Copenhagen, Dept. of Neurol-ogy, Copenhagen, DENMARK3 Background The awareness of atrial fibrillation (AF) has increased in resent years leading to imple-mentation of telemetry and other methods of atrial fibrillation detection in stroke unit care. Further, the risk of AF rises with age, and the prevalence and incidence of AF are rising as population age in-creases, meaning a potential rise in severe strokes. Focus has been to identify more patients with AF in order to prevent stroke. Aim of study was to examine the trends in 1) incidence of diagnosed AF in patients after acute ischaemic stroke, and 2) the development in use of oral anticoagulants (OAC) in Denmark from 2003-11. Methods Data was obtained from a nationwide registry on patients with acute stroke in the period 2003-2011 with a data-completeness of >90%. Patients ≥ 18 years of age with a final diagnosis of ischaemic stroke were included into this analysis. Results From 2003 to 2011, 105.833 patients were discharged with a diagnosis of stroke in Denmark, 52,5 % were diag-nosed ischaemic stroke (IS), 8,42 % with ICH, and 39,1 % with unclassified stroke. Within patients with IS, 17,5 % had diagnosed atrial fibrillation in 2003 increasing to 20,5 % in 2011, this increase was significant (p<0,0001). In patients with IS and AF, OAC was administered or a contraindication was identified in 11,1 % in 2003 vs 44,7 % in 2011 (p<0,0001). Conclusion: Both the rates of AF detection and the use of OAC have increased from 2003 - 11. This is like to reflect increasing aware-ness of AF and increased use of monitoring. In an ageing population the frequency of AF is likely to increase, however, we do not believe this factor as a major contributor to results. The use of OAC has increased markedly, however, under-treatment is still most likely a reality.
Karger_ESC London_2013
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