22. European Stroke Conference 279 Etiology of stroke and risk factors Subclinical macrovascular complications in patients with Type 1 diabetes mellitus I. Vastagh1, T. Horváth2, G. Nagy3, T. Varga4, E. Juhász5, V. Juhász6, M. Kollai7, D. Bereczki8, A. Somogyi9 Department of Neurology, Semmelweis University Faculty of Medicine, Budapest, HUNGA-RY1, Institute of Human Physiology and Clinical Experimental Research, Semmelweis University Faculty of Medicine, Budapest, HUNGARY2, 2nd Department of Internal Medicine, Semmelweis University Faculty of Medicine, Budapest, HUNGARY3, 2nd Department of Internal Medicine, Semmelweis University Faculty of Medicine, Budapest, HUNGARY4, 2nd Department of Internal Medicine, Semmelweis University Faculty of Medicine, Budapest, HUNGARY5, 2nd Department of Internal Medicine, Semmelweis University Faculty of Medicine, Budapest, HUNGARY6, Insti-tute of Human Physiology and Clinical Experimental Research, Semmelweis University Faculty of Medicine, Budapest, HUNGARY7, Department of Neurology, Semmelweis University Faculty of Medicine, Budapest, HUNGARY8, 2nd Department of Internal Medicine, Semmelweis University Faculty of Medicine, Budapest, HUNGARY9 Background: Type 1 diabetes mellitus is an important risk factor for microvascular disease and large vessel dysfunction. We examined the morphological and functional characteristics of large elastic arteries and evaluated the early signs of atherosclerosis in type 1 diabetes mellitus. Methods: We studied 50 patients with type 1 diabetes and 50 healthy control subjects matched for sex and age. We investigated morphological (intima-media thickness, intima-media cross-sectional area) and func-tional features (compliance, distensibility, circumferential strain, stiffness index, incremental elastic modulus) of the common carotid arteries, and carotid-femoral pulse wave velocity (PWV). The ca-rotid artery was examined with an ultrasonographic vessel wall-movement tracking device. Carotid pressures and PWV were determined with applanation tonometry. Brachial BP, anthropometric and metabolic parameters (serum lipids, fasting blood glucose, HbA1C and C-reactive protein) were measured. Results: Intima-media thickness (570±90 vs. 526±67 μm, p<0.05) and intima-media cross- sectional area (13.12 ±2.92 vs. 11.64±1.98 mm2, p<0.05) were significantly larger in diabet-ic patients. The functional parameters suggested stiffening of common carotid arteries in diabetic patients. Dividing patients by ≤ or > 10 years of disease duration, the morphological parameters, the PWV and the stiffness index showed progressing damage (p<0.05) of large elastic arteries in long-standing diabetes. Conclusion: The morphological parameters, the PWV and the stiffness index reflect a progressive damage to large elastic arteries in Type 1 diabetes mellitus. Of these markers the intima-media cross-sectional area is most sensitive, therefore should be considered to be intro-duced into the evaluation of large vessel damage in diabetes mellitus. 434 © 2013 S. Karger AG, Basel Scientific Programme 280 Etiology of stroke and risk factors Cerebrovascular complications in patients with haematological malignancies C.J. Schwarzbach1, A. Ebert2, M.G. Hennerici3, M. Fatar4 Department of Neurology, UniversitätsMedizinMannheim, University of Heidelberg, Mann-heim, GERMANY1, Department of Neurology, UniversitätsMedizinMannheim, University of Heidelberg, Mannheim, GERMANY2, Department of Neurology, UniversitätsMedizinMannheim, University of Heidelberg, Mannheim, GERMANY3, Department of Neurology, UniversitätsMediz-inMannheim, University of Heidelberg, Mannheim, GERMANY4 BACKGROUND: Patients with leukaemia are considered to be at increased risk of intracranial haemorrhage and patients with essential thrombocythaemia of ischemic stroke. However, the call for case-controlled studies addressing these assumptions has not been heard yet and little is known about the overall importance of haematological malignancies in the aetiology of stroke. METHODS: We identified 39 patients sequentially admitted to our comprehensive stroke centre be-tween the years 2002 and 2012 with the additional diagnosis of leukaemia or myeloproliferative dis-order. Stroke aetiology expressed by the ASCO Score as well as risk factors, imaging patterns and laboratory findings were compared between stroke patients with haematological malignancies (H) vs. an age and gender matched control group of stroke patients with mixed aetiologies different from haematological disorders (C). RESULTS: Prevalence of conventional stroke aetiology (CSA - defined by ASCO Grade 1 or 2 ex-cept for haematological aspects) and risk factors did not differ significantly between group H and C (CSA group H: 10/37(27%) vs. CSA group C: 15/34(44%); p=0.1). Frequency of intracerebral haemorrhage was not significantly different either (group H: 4/39(10%) vs. group C: 2/39(5%); p=0.34), as was the risk of secondary haemorrhage (H: 1/30(3%) vs. C: 3/31(10%); p=0.32). Lesion pattern including lacunar infarction (H: 8/30(27%) vs. C: 6/31(19%); p=0.35) and embolic infarc-tion (H: 11/30(37%) vs. C: 11/31(35%); p=0.54) did not differ. Only one patient was diagnosed with sinus venous thrombosis and other thromboembolic complications were not described. CONCLUSION: To the best of our knowledge this is the first case-controlled analysis so far evaluat-ing stroke characteristics and aetiology in patients with haematological malignancies. Our data sug-gests that the risk of intracerebral haemorrhage and the importance of haematological malignancies in the aetiology of stroke have been overestimated.
Karger_ESC London_2013
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